Model Public Report Elements: A Sampler

II. Five Basic Elements (Web Pages) of a Public Report: Options and Ex

A. Landing Page or Information Accessible From Landing Page

The landing page—the first view of the Web site—is key and can either invite users in or drive them away. It can motivate use of the information, help consumers understand the benefits of comparative performance data, and help consumers understand how to apply the information to their choices.

Because using comparative information on provider quality is new to most health care consumers, they need to understand what the information means, how it may help them, and what they can do to improve their chances for excellent care and improved health outcomes. Assume that your target audience of consumers has a limited understanding of the concept of health care quality. You have an opportunity to provide a definition of quality to consumers when they are eager to learn about it, given that they have initiated access to the site. Being clear about what is meant by "health care quality" and explaining that it is now possible to measure and compare health care providers on their quality of care will help set the context for using the information.

1. Motivating use of the information and defining the benefits

It is important to help consumers see how they can use comparative quality information to select a provider or engage providers in a discussion of quality. Making links between consumer concerns and comparative data is one way to achieve this goal. Consumers also may be more motivated to use comparative data if the degree of variability in quality is made explicit and the dangers of receiving poor quality care are clear.

2. Explaining possible uses of the data

Provider quality ratings are new to most consumers, so the report offers an opportunity to help them understand the different ways they can use the information to their benefit.

This site highlights for consumers both how to use the information (top) and the benefits of doing so (bottom excerpt).

Tool: Clinical Quality in Primary Care

Sponsor: Massachusetts Healthcare Quality Partners

URL: http://www.mhqp.org/quality/whatisquality.asp?nav=030000  

Screenshot of Quality Insights: Healthcare Performance in Massachusetts Web page, with arrows pointing to How can health care quality data help patients and their family members and How can people hhelp improve the quality of their health care?

3. Communicating about a shared responsibility

Consumers do not always understand what their role is in the care process or that their active participation can increase their chances of a good health outcome. Explicitly communicating that care is a shared responsibility between patients and providers is an important way to reinforce this behavior.

These next examples show strategies for communicating about the different ways consumers can use and benefit from information. The following example uses video to discuss the shared responsibility that patients and providers have in determining quality.

Tool: Doctor Ratings

Sponsor: Maine Health Management Coalition

URL: http://www.mhmc.info/interviews/  

Screenshot of Maine Health Management Coalition doctor ratings Web page. Links include doctor ratings, hospital ratings, surgery ratings, and How do I get quality care? Arrows point to screen captures of two video interviews with a female patient and a male patient.

Here is an example of a disease-specific report that speaks to the importance of the patient's role in the care process.

Tool: D5

Sponsor: Minnesota Community Measurement

URL: http://www.thed5.org/index.php?p=about_the_d5  

Screenshot of About the D5, the 5 steps of diabetes care: control blood pressure, lower bad cholesterol, maintain blood sugar, be tobacco free, and take aspirin daily. An arrow points to the text that emphasizes the importance of people with diabetes working with their health care providers to manage the disease.

4. Defining quality of care and providing consumers with a framework for understanding quality

Research shows that when consumers have a better understanding of the larger concept of quality and the elements that make up good quality care, they also tend to have a better understanding of individual quality indicators and view comparative information as more useful.

The example below provides a brief description of what high quality care is, which is referred to as "care that works best."

Tool: Partner for Quality Care

Sponsor: Oregon Health Care Quality Corporation

URL: http://www.partnerforqualitycare.org/getcare.php ��

Screenshot of Partner for Quality Care Web site, with link to brochure on getting care that works. An arrow points to the text that asks Are you getting care that works the best?

5. Describing the collaborative membership

Some visitors will be interested in who funds, designs, and produces the report. Some sources are more trusted than others. Having an "About Us" section showing multistakeholder input may help establish credibility. Below are three examples.

The About Us page on the Maine Health Management Coalition (MHMC) site below includes a comprehensive list of "the employers, doctors, health plans, and hospitals who are members of MHMC."

Tool: Maine Doctor Ratings, Maine Hospital Ratings, Major Surgery Ratings

Sponsor: Maine Health Management Coalition (MHMC)

URL: http://www.mhmc.info/about/  

Screenshot of Maine Health Management Coalition Web page, with links to doctor, hospital, and major surgery ratings, as well as How do I get quality care? An arrow points to the text describing the coalition's members, which is followed by photos of the CEO, medical advisor, and project leaders.

This "About" page allows the user to find out about the membership, activities, and goals of the organization.

Tool: Performance & Progress Report

Sponsor: The Wisconsin Collaborative for Healthcare Quality

URL: http://www.wchq.org/about/  

Screenshot of Wisconsin Collaborative for Healthcare Quality Web page, with arrow pointing to text in the Who We Are section. The page also describes what we collaborate to do, what we aspire to be, and how we began.

This page provides clearly categorized links to each stakeholder organization. The Board of Directors page provides additional details on represented organizations.

Tool: Virginia Health Information: From Numbers to Knowledge

Sponsor: Virginia Health Information (VHI)

URL: http://www.vhi.org/about_stakeholders.asp  

Screenshot of Virginia Health Information Stakeholders page wiith links to Business, Hospital, Insurance, Nursing Facility, Physician, and State organizations. An arrow points to these links, and another arrow points to the Board of Directors link.

6. Explaining rules concerning use of information by other organizations

Some collaboratives have developed "Rules of Use" for other organizations that may be interested in using some or all of the information. For example, others may be interested in using the data for other public reports, provider advertisements, or provider negotiations. Rules of Use statements may include restrictions about the business use of the data, changes in how the data are presented, ways to cite the data, and steps to get approval of use of a collaborative's data or logo.

The following three examples illustrate Rules of Use with varying levels of detail and emphasis.

The following example includes a brief statement on the intended uses of publicly reported data.

Tool: Take Charge for Better Health, Using Information To Get Good Care

Sponsor: Healthy Memphis Common Table

URL: http://www.healthymemphis.org (organization) and http://www.healthymemphis.org/assets/docs/Reports/HMCT%20report%202%20111609R.pdf (document) (PDF File; Plugin Software Help)

Excerpt of Take Charge for Better Health document describing allowable uses of the reports and how to notify the Healthy Memphis Common Table of misuse.

The guidelines below provide recommendations for acknowledging data limitations, using publicly reported performance results for marketing, and using results for financial and business purposes. Specific examples of what is and is not appropriate are also provided.

Tool: Partner for Quality Care, Guidelines for Using Performance Results

Sponsor: Oregon Health Care Quality Corp

URL: http://www.partnerforqualitycare.org/index.php (organization) and http://www.partnerforqualitycare.org/pdf/guidelines_performance.pdf (document) (PDF File; Plugin Software Help)

Excerpt from Guidelines for Using Performance Results showing recommendation 3, use of results for marketing, and recommendation 4, use of results for quality improvement and financial purposes. Both recommendations are followed by tables indicating appropriate and inappropriate ways to share data.

The file available from the Rules of Use includes four pages describing optimal uses of the results; restrictions on use during report development; a guide to interpretation of results; directions for submission for review before use; specific guidelines for citations and logo use; prohibition on composite measures; and insistence that reporting conventions be upheld.

Tool: Community Checkup Report

Sponsor: Puget Sound Health Alliance

URL:http://www.pugetsoundhealthalliance.org/ (organization) and http://www.pugetsoundhealthalliance.org/resources/documents/RulesforUse_2009.pdf (document, PDF File; Plugin Software Help)

Screenshot of Health Alliance Community Checkup legal notice and disclaimer page with link to Rules of Use. Below this screenshot is an excerpt from the Puget Sound Health Alliance Rules of Use for Performance Results in the Community Checkup Report.

7. Providing legal notices and disclaimers

Some collaboratives add a legal disclaimer when allowing users to access data. Most often, such disclaimers state that the collaborative cannot be liable for the accuracy of the data. In some cases, the user is required to go to the disclaimer before accessing provider scores. In other cases, the disclaimer is simply available on the Web site.

The following three examples illustrate a disclaimer that is just available as a link, a disclaimer that asks users to accept certain terms of use when they select the search button, and a disclaimer that appears in a popup box with an Accept button that users must select before any data are displayed.

The legal disclaimer below can be found by selecting the "Disclaimer" link at the top of the NH QualityCare Web site.

Tool: �NH QualityCare

Sponsor: Foundation for Healthy Communities and Northeast Health Care Quality Foundation. NHQualityCare.org is a partnership between the Foundation for Healthy Communities and the Northeast Health Care Quality Foundation.  

URL:http://www.nhqualitycare.org/disclaimer.php  

Screenshot of NH QualityCare disclaimer page with arrow pointing to Disclaimer link at top of page.

The search page below links to terms of use, which consumers are asked to accept in order to search by ZIP Code for patient experience data.

Tool: �What Patients Say About Their Doctors

Sponsor: Consumers' CHECKBOOK/Center for the Study of Services (CHECKBOOK/CSS), in collaboration with the Kansas City Quality Improvement Consortium and health plans

URL: http://www.checkbook.org/patientcentral/?cb=kcqic&ref=xxx  

Screenshot of Kansas City Quality Improvement Consortium Web page, What Patients Say About Their Doctors. The page describes the data that are available. In the middle of the page is a text box for users to enter their ZIP Code and a statement that indicates that by clicking the Search button to view the doctor ratings, the user agrees to the Terms of Use. A link is provided to Terms of Use.

This popup box appears with Terms of Use and an Accept button that users must select in order to access the data. The Terms of Use include a detailed legal disclaimer.

Tool: �CalHospitalCompare.org

Sponsors: California Hospital Assessment and Reporting Taskforce, the California HealthCare Foundation, and the University of California, San Francisco

URL: http://www.calhospitalcompare.org/profile.aspx?h=147  

Screenshot of CalHospitalCompare Web page for Rating Hospital Quality. The page is faded out with a popup box over it with Terms of Use and an Accept button.
Current as of November 2011
Internet Citation: Model Public Report Elements: A Sampler: II. Five Basic Elements (Web Pages) of a Public Report: Options and Ex. November 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/pubrptsampler/pubrptsampl2.html