New Study Shows Online Physician Directories Need to Be Vastly Improved to Be Useful to Patients

(Chicago IL)—A new study assessing the utility of online physician directories shows that despite the increased use of the Internet, consumers resist using these resources for a variety of reasons, preferring instead to rely on personal recommendations when looking for a doctor. The findings show that more detailed, relevant, accessible data need to be available to make online directories a more useful tool to help consumers choose their doctors and physicians make patient referrals. The Finding Doctors in Chicago project was conducted by the Chicago-based Midwest Business Group on Health (MBGH) and sponsored by the Commonwealth Fund in New York. The project sought to determine the feasibility of adopting national standards for physician directories; identify barriers to making improvements; and evaluate consumer and physician attitudes toward online directories. The study also looked at how new standards from the National Committee for Quality Assurance (NCQA) can be used to improve online directories. The MBGH, a coalition of 70 employers working to improve the quality and value of health benefits, surveyed more than 2,250 consumers online and asked how they went about finding a doctor and what information was most useful in selecting a physician. MBGH worked with local providers and networks in the region that had online physician directories or were developing one and were willing to compare and enhance those using NCQA guidelines: Advocate Health Care, Blue Cross Blue Shield of Illinois, Chicago Medical Society and Evanston Northwestern Healthcare. "The project demonstrated wide variations in the quality and content of physician directories," says MBGH President Dr. Dennis Richling. "We hope our results help raise the bar for physician directory sponsors who need to respond to consumers' desire for credible and useful information about physicians practicing in the Chicagoland area," he says. "The decision to select a doctor is an important one. This task is made even more difficult given that the sources of information about doctors are not easy to find, and it is difficult to know which of those sources can be trusted," says Anne-Marie J. Audet, MD, Assistant Vice President, Quality Improvement at the Commonwealth Fund. "Even though this project looked at finding doctors in Chicago, the lessons learned apply anywhere," Audet adds. The study found that:

• Consumers are unaware of the extent of physician data available on the Internet and have limited experience using online directories.
• Many consumers do not understand some of the NCQA measures, such as mortality or volume, and do not consider them important.
• Directory sponsors should promote more than just the ability to find a doctor, and include information about physicians and recommended links to other Web sites.
• Consumers do not feel comfortable using an online physician directory as the sole method to find a doctor. They tend to use the directories as a way to validate their choice.
• Consumers prefer doctors who are easy to reach, use favored hospitals, are covered by their health plan, and have similar backgrounds.

Physicians also indicated that they are reluctant to use online directories; one third of 22 physicians surveyed said they would never use online directories and the rest said they would use it only to support referral decisions. Physicians expressed concerns about the accuracy and reliability of information found in online directories. There also appears to be a conflict between the information desired by consumers and the information physicians are willing to make publicly available. Physicians do not believe that malpractice history, disciplinary actions, or clinical performance should be included in directories because of the potential for misunderstanding among patients. In contrast, consumers view this information as highly desirable. There remain significant barriers to providing the kind of information consumers want. Directory sponsors reported they often do not have access to medical practice or clinical performance data due to liability or other issues. Based on the findings, MBGH developed a set of recommendations for the sponsors of online physician directories. These include:

• Maximizing the ease and use of navigation;
• Providing information that helps consumers learn more about a physician; and
• Ensuring the credibility and usability of data

The authors also recommend developing a standard template for communities to use in pooling physician data among participating directory sponsors to better meet consumer demand and NCQA recommendations. They also suggest creating a central repository for sensitive physician information such as patient satisfaction data, malpractice history, disciplinary actions, and clinical performance data. The Chicago-based Midwest Business Group on Health is a business coalition dedicated to improving the efficiency and quality of the health care services delivered to workers as well as increasing their health status. MBGH represents over 70 employers who provide coverage for approximately 800,000 lives. The Finding Doctors in Chicago report is available in the "Quality & Community Initiatives" section of MBGH's website at www.mbgh.org/fdc/. The Commonwealth Fund is a private foundation that supports independent research on health and social issues and makes grants to improve health care practice and policy. Copies of the report Finding Doctors in Chicago can be obtained online at www.commonwealthfund.org.