Research on Reporting Information to Consumers

The ability to report CAHPS^® survey results in a way that supports consumers in making informed decisions has been a key element of the CAHPS project since its inception in the mid-1990s.¹ Over the years, the CAHPS grantees have conducted numerous studies to answer key questions:

• What are the best ways to report CAHPS survey results so that they are understandable and usable?
• How do the users of CAHPS surveys actually report the results?
• What effect does the reporting of CAHPS survey results have on consumers and their choices?

More recently, CAHPS researchers associated with the Yale and RAND grantee teams have been focused on the following projects.

Reporting Patient Narratives

There is increasing interest in incorporating patient narratives into consumer reports that also contain standardized measures of healthcare quality—including but not limited to CAHPS survey measures. The CAHPS team used a fictitious public reporting site called SelectMD to explore ways to use narratives to enhance consumers' understanding of standardized measures of quality, engage consumers in healthcare decision-making, and more effectively convey patient-reported experience.

Learn more about this project:

• Reporting Patient Narratives with Standardized Measures of Quality (PDF, 125 KB)
• Public Reporting of Patients' Comments with Quality Measures: How Can We Make It Work? (Webcast; June 3, 2014)

Review findings from this project:

• Kanouse DE, Schlesinger, M, Shaller D, et al. How patient comments affect consumers' use of physician performance measures. Med Care 2016 Jan;54: 24–31.
• Martino SC, Grob R, Davis S, et al. Choosing doctors wisely: can assisted choice enhance patients' Selection of Clinicians? Med Care Res Rev 2017 Nov 25. doi: 10.1177/1077558717743822. [Epub ahead of print]
• Schlesinger M, Grob R, Shaller D. Using patient-reported information to improve clinical practice. Health Serv Res 2015; 50: 2116–2154.
• Schlesinger M, Kanouse DE, Martino SC, et al. Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior. Med Care Res Rev 2014; 71: 38S–64S.
• Schlesinger M, Kanouse DE, Rybowski L, et al. Consumer response to patient experience measures in complex information environments. Med Care 2012; 50: S56–S64.

The Use of Summary Scores in Consumer Reports

One of the challenges facing the developers of consumer reports on healthcare quality is the complexity of the information, particularly when consumers have to consider multiple pieces of information to make a decision. Summary scores, which combine the scores for multiple measures of healthcare quality, are regarded as a promising solution to that challenge. However, summary scores have both positive and negative features, and the impact of summary scores on consumer decision-making has not been not well understood.

The CAHPS team explored these issues through two research projects:

• A test of consumers' reactions to three levels of information for clinical measures, patient experiences measures, and safety measures: summary scores provided with detailed quality scores, summary scores only, and detailed scores only. Read the findings:  Cerully JL, Parker AM, Rybowski L, et al. Improving patients' choice of clinician by including roll-up measures in public healthcare quality reports: an online experiment. J Gen Intern Med 2018 Nov 16. doi: 10.1007/s11606-018-4725-y. [Epub ahead of print]
• An investigation of current uses of summary scores in consumer reports and the perspectives of both report developers and key stakeholders in the reporting process. Read the findings: Cerully JL, Martino SC, Rybowski L, et al. Using "roll-up" measures in healthcare quality reports: perspectives of report sponsors and national alliances. Am J Manag Care 2017; 23: e202-e207.

Learn more about this topic:

• Combining Health Care Quality Measures Into Composites or Summary Scores (AHRQ’s TalkingQuality Web site)

¹Read about the critical role of reporting research in: McGee J, Kanouse DE, Sofaer S, et al. Making survey results easy to report to consumers: How reporting needs guided survey design in CAHPS. Med Care 1999;37(3 suppl):MS32–40.