States might be ahead of the curve when it comes to medical-error reporting systems, but consumers still don't seem enthusiastic about using the information provided to make healthcare choices.
Reporting systems have benefited from the digital age: Data are collected more quickly via Web-based processes that allow practitioners to enter information and send it directly to state databases. The data typically are turned into public reports shared on Web sites, which patients can peruse to see comparisons among physicians and healthcare facilities.
However, there's little information to suggest patients are doing so, or that such reports are effective in the drive for higher healthcare quality.
Researchers who studied whether there is evidence for using publicly released performance data to improve quality found a lack of rigorous evaluation of reporting systems and could not determine the influence reporting had on patient behavior. Published in the Jan. 15 Annals of Internal Medicine, the study concluded that reporting systems could cause more confusion for people as well.
"Despite its theoretical appeal, making public reporting work requires successfully addressing several challenges," wrote the authors of Systematic Review: The Evidence that Publishing Patient Care Performance Data Improves Quality of Care.
"Evidence suggests that poorly constructed report cards may impair consumers' comprehension of these measures and may cause consumers to make decisions that are inconsistent with their goals."
Constance Fung, a physician and lead researcher for the study, said she was surprised that only a few older reporting systems had been evaluated, and that many newer ones have never been scientifically examined. "There are many out there that have not been evaluated. Report cards are not all built the same," said Fung, now a content developer with Zynx Health, Los Angeles, which develops clinical summaries and details of best practices based on studies of peer-reviewed literature. Fung was affiliated with RAND Corp. while she conducted the reporting study.
The problem is that the information reported is not specific enough, according to Helen Haskell, president of Mothers Against Medical Error, a Columbia, S.C.-based patient-safety organization working to reduce the number of medical errors made in hospitals.
Most public reports, such as report cards, tell consumers about processes that are considered the proper steps leading to improved outcomes, such as giving aspirin to heart attack patients.
These types of reports usually don't provide specific information about the actual outcomes and what complications might arise from certain medical procedures, said Haskell, who is skeptical that public reports can lead to healthier patients. "At this point, I doubt it," she said.
While medical-error reports don't seem to be affecting individual patient behavior, they do prompt hospitals to pay attention to quality-improvement initiatives in their facilities, Fung said. However, there has been little study of its influence in increasing patient safety or patient-centered care, she added.