Craig Brammer
Director,
Cincinnati AF4Q

We all know that the overall health of patients, and their satisfaction with their health care, are greatly enhanced if they are informed consumers and engaged in the process. But some major roadblocks exist. Many health care consumers:

• Don’t know what high quality care looks like or if they are receiving it
• Aren’t aware of how their physicians perform in relation to their peers
• Leave responsibility for their health in the hands of their doctors

Consumer engagement — encouraging patients to be active managers of their health care and make informed choices about their doctors — is one area of reform that experts believe is essential to improving health care quality. Cincinnati Aligning Forces for Quality (AF4Q) made much progress over the last year in this critical area.

Engaging Consumers Regarding
Diabetes Care: Results to Date

A community-wide Diabetes Footprints Campaign (DFC) launched last year and provided informative tools such as www.diabetesfootprints.org that define best practices for care in the doctor’s office and patient self-management at home. These tools were informed by national and local consumer research, including local focus groups that explored patients’ feelings about their disease, their care and self-management.

Our goal was to distribute 100,000 printed DFC decision support tools by the end of this year and we are at about 95 percent, thanks to the more than 50 local health care and community organizations that are partnering with us in this effort.

The Role of Public Reporting

Consumer engagement efforts that led to the Diabetes Footprints Campaign laid the foundation for our region’s readiness for public reporting.

Next year we will launch the region’s largest and most comprehensive public reporting initiative for diabetes outpatient data. By the summer of 2010, residents in Greater Cincinnati will be able to compare the performance of their primary care practice with other practices in the area through a public website being developed by Bridge Worldwide, a leading digital marketing agency in Cincinnati.

Using nationally accepted metrics, local physicians, employers and health care insurers are working together to standardize quality measurements of care for patients with diabetes in the Greater Cincinnati region. These standards will be reported, along with practice performance ratings. A pilot group of physicians in the region is already submitting data, and Cincinnati AF4Q is working toward the goal of publicly reporting performance measures for 50 percent of area primary care physicians by summer 2010. Diabetes is just the beginning. In the future, Cincinnati AF4Q will report performance measures on additional conditions and clinical settings.

We know that public reporting raises quality of
care — transparency motivates doctors to improve quality and it helps patients make better choices. What is unique about Cincinnati’s public reporting effort is the consumer-centric approach we’re using in designing the website and the promotions plan. None of the other 14 AF4Q markets are utilizing consumer insight to this degree, and our work is being recognized across the country as pushing the envelope on how best to engage consumers.

Public Reporting:
What Consumers Think About It

Judy Hirsh, a Procter & Gamble health care marketer, has led groundbreaking research on how best to engage the public in health care quality measurement, and is chair of the AF4Q Consumer Engagement Workgroup. Her research is being used to: guide our plans on motivating consumers to learn about public reporting; determine the clearest way to report the data; explore viable names for the website; and identify additional features that could be incorporated into the website. (Click here to view some of the “mood boards” that were tested.)

Here are some of the key learnings:

• Consumers lack a sense of the overall quality of care provided in Cincinnati.
• Consumers welcome having comparative information about outcomes. They believe it offers many benefits to them and to their physician.
• For consumers, quality of care is as much about the emotional connection with their provider as it is about clinical outcomes.
• If the practice is not highly rated, most consumers want to work with their doctor rather than switch to another. They say they would ask their doctor about the performance rating score to find out why it’s low and what the practice is doing to improve. They believe the data will empower them to initiate the conversation.
• Consumers want to understand what they should be doing for themselves.
• Consumers expect a website to include a range of information in addition to performance data.

This consumer feedback is being considered in nearly every aspect of the website design, from visuals and language, to features and functions, and the way in which ratings are presented. Consumers were clear: They want the public reporting website to emphasize joint accountability, reminding patients that both the physician and patient have a role in improving care.

Where Do We Go From Here?

Before website design is finalized, more physicians throughout the region will be consulted for their feedback, and consumers will test the site’s ease of use. Then Judy and the team will work in partnership with key stakeholders to create plans for promoting public reporting to consumers before the site launches next summer.

We believe that all of these consumer engagement efforts and tools will ultimately boost patients’ understanding of their role, both in self-management and in demanding high quality care. We believe that when consumers are informed and understand the role they can play in their overall health… when they use quality of care information in their decision-making… overall health is improved and health care costs go down.

Engaged consumers are one piece of the health care quality puzzle, and if we continue to make strides in this critical area, I’m certain it will lead to improved health and health care across Greater Cincinnati.

Sincerely, Craig Brammer Director, Cincinnati AF4Q