An academic medical center is an interesting and matrixed leadership organization. There are two groups that both have there own sets of leadership and different motivations and interests. On the one hand is the physician group, they provide the care for the patients while also holding an academic responsibility in teaching and training students. Their focus is on providing care to patients and education for students. They report up through an academic hierarchy of leadership. On the other hand is the Hospital group who provides the business and system structure for the providers including facilities and operations. Their focus is on care delivery, business functions and operations.
Over several years the information describing the faculty had evolved from an academic viewpoint and didn’t really serve the customer. A group supporting the physicians from the academic side had built a physician search based on this academic data. Additionally for the U of U campus a tool existed to search all appointed faculty.
Each department had a variety of faculty pages they created manually on there academic websites or linked to a faculty search. On the clinical websites we had a group that was setup by the physicians to create electronic CV’s that held basic information such as providers name, phone number, bio, publications, department info etc. They leveraged this to create a doctor search tool.
The Problem
A number of problems existed with the current way of doing thing including:
- Duplicated content, wasted resources.
- Unused but useful data.
- Fear of transparency.
- Hierarchal department viewpoint.
- Consumerism and competition set new expectations.
While there were databases with a big chunk of the needed information there were still many manual pages created. This led to information being out of sink and having to update information in multiple places.
The physician search was not structured in a way that was all that useful for patients. It also was not integrated in the user journey and displayed in a way that made it easy to find and use. Consumers wanted a connected experience providing all the relevant information needed to make a decision about the doctor they would choose. I reached out to the medical group team that managed the find a doctor tool and cv data and asked if I could rebuild the tool. They would provide the front end for the physicians to enter the data and provide a webservice for us while we focused on the presentation. They were happy to oblige as it was tough for them to keep in synch with our design changes.
The Solution
I began building out both the search tool but also integrations on disease and treatment pages so we could dynamically display lists of doctors. I integrated additional data sources on top of original data source including news, clinical trials, videos.
Since 2008 reviews were being collected and shared internally but In 2012 I was tasked with adding physician reviews to our website. In 2012 we became the first hospital system to display physician reviews. A critical piece to this was some changes google had been implementing with structured data and serp’s. I had been keeping up with changes to google and knew from my own consumer goods research that google was experimenting with displaying star ratings in the SERP for products and businesses. What if we could do the same for providers? I researched all I could about JSON-LD and structured metadata, I built out a prototype page and tested it out with some tools. It appeared to work and display ratings at least in test. We made the changes to production and anxiously awaited. To our delight google picked up the structured data and displayed big stars and ratings for our providers while the competition had none. Additionally people feared there bad reviews but soon discovered that the handful of negative reviews gave the reviews more credibility and showed we didn’t white wash the data.
The Outcome
After we rolled out the structured data for star ratings we saw an immediate 4x jump in page views and a similar growth in appointments from doctor profiles. Interesting side effect is ratings increased as they became transparent. It impacted doctor behavior. And for the doctors with higher star ratings we saw an increase in appointment requests compared to those with lower ratings. We were the first hospital system to post online reviews of our doctors. A slew of media attention and peers clamored to know how we did it. We generated a whole host of business who began providing tools for systems to do this and healthcare embraced the consumer journey and being transparent with there review data.
I worked with a Harvard researcher Henry Eyring who did his dissertation on the impact of reviews and he found “Preliminary results showed a causal effect of star rating posting on web traffic of 47 additional page-views to a physician’s web-page per-month, and 11 additional seconds per page-view“
Lessons Learned
Continuous iteration. There is a huge backlog of work to improve our physician profiles. Since its a centralized tool its not really top of mind for anyone but knowing our analytics its the place that generates the most conversions and creates the biggest impact when we make improvements. People ultimately decide on an individual provider when scheduling for anything beyond urgent care.
Utilizing a data source improves the accuracy of the data and the stewards become close partners as they see the value you bring. This then allows for further iterations and improvements, a willingness to provide additional data fields and adjustments to suite.
Understanding the consumer/customer journey for other industries sets expectations. Look outside your own industry for innovations.
Stay on top of technology, this allowed us to take advantage of google structured data and star ratings just as it was being rolled out giving us a very big strategic advantage with big visual callouts from our competitors.
Strong leaders not averse to risk are required for tough decisions. Putting reviews out for the public was very scary for the physicians. Would this ruin there practice if they had a negative review? I simply had to point to external reviews that where already being generated and they lived in the extremes of either 1’s or 5’s. They really had little to loose and everything to gain.
What is measured changes behavior, what is measured and shared publicly changes behavior rapidly. Reviews shared internally did not have as big an impact on the provider as reviews shared externally. U of U Health went from being 34th percentile to 80th percentile in patient satisfaction and jumped into the top 10 for quality in the nation and has remained there for the last 12 years.
References
- Physician reviews lead transparency efforts – https://healthcare.utah.edu/publicaffairs/news/2014/04/04-22-14-physicanreviews.php
- University of Utah leads transparency efforts – https://www.prnewswire.com/news-releases/university-of-utah-health-cares-online-physician-reviews-continue-to-lead-transparency-efforts-in-academic-medicine-256334261.html
- Doctor ratings empower and educate patients – https://www.ksl.com/article/33820445/doctor-ratings-empower-and-educate-university-of-utah-patients