Q . What is the value proposition of My Doctor Knows?
My Doctor Knows helps patients who want to choose a provider or hospital based on value (i.e. how effectively they practice medicine according to reports made by patients on our site). Unlike the current standard today, by measuring patient outcomes, and creating transparency, My Doctor Knows creates a HIPAA* compliant, secure environment in which patients can make truly informed choices about their healthcare. This improves provider efficiency and effectiveness, resulting in demonstrably better patient outcomes. My Doctor Knows is owned and operated by Avecin Corp., a Delaware Corporation.
Q . Where does your data come from?
We collect outcome data from integrating various - Federal and State public databases in order to display the outcome data on 3.9 million U.S. providers and over 4,800 U.S. hospitals in a meaningful way for users. Additionally, we collect patient-reported outcome data based on clinical standards. Future data sets shall include providers and hospitals in Europe, Asia and South America.
Q . Where does CMS say about using their data?
CMS data for Physician Compare URL https://data.medicare.gov/data/physician-compare states:
Works of the U.S. government are in the public domain, and permission is not required to use them. An attribution to the Centers for Medicare & Medicaid Services (CMS) as the source is appreciated. However, Physician Compare data, including performance information and star ratings, should not be construed as an endorsement by the U.S. Department of Health and Human Services of any clinician’s products or services. Conveying a false impression of government approval, endorsement or authorization of products or services is forbidden. See 42 U.S.C. 1320b-10.
The performance information, star ratings, and all data on Physician Compare are provided as a service to the public, and are not intended to grant rights or impose obligations. The assessment of performance included on Physician Compare is limited in scope to the data sources used. A clinician’s performance on an individual measure or domain may not be reflective of that clinician’s overall quality of care.
CMS Hospital Compare Data URL https://www.medicare.gov/hospitalcompare/Data/About.html states:
Works of the U.S. government are in the public domain, and permission is not required to use them. An attribution to the Centers for Medicare and Medicaid Services as the source is appreciated. However, Hospital Compare data, including star ratings, should not be construed as an endorsement by the U.S. Department of Health and Human Services of any health care provider’s products or services. Conveying a false impression of government approval, endorsement or authorization of products or services is forbidden. See 42 U.S.C. 1320b-10.
The star ratings and all data on Hospital Compare are provided as a service to the public, and are not intended to grant rights or impose obligations. Star ratings are limited in scope to the data sources they are derived from. Get details on Hospital Compare data sources and an explanation of the Hospital Compare star ratings methodology. A provider’s star rating on an individual measure or domain may not be reflective of that provider’s overall star rating.
Q . How many miles from my zip code will I get results for?
By default, you’ll see results for a radius of 100 miles from your zip code. However, we have noticed that if a provider does not update their address or works at multiple sites you might not find them in the results. We recognize this is frustrating, but rely on providers to update their information. In the cases where there is an error please let us know at email@example.com. Note, on the results page, you will be able to choose a different radius.
Q . What is the “Outcome Score” of a Provider?
The “Outcome Score” is an overall rating of a Provider based on outcome metrics. Health outcomes are measured by medical condition or primary care patient segment, and reflect the full cycle of care for the condition. The Outcome Measures Hierarchy is divided into three tiers: 1) Health Status Achieved or Retained 2) Process of Recovery 3) Sustainability of Health.
Tier 1 Health Status Achieved or Retained – This tier focuses on the initial patient outcome that determines whether a patient can return to a functional status and survives in the most severe conditions. This is measured over a period of years, from one to five years depending the severity of the condition.
Tier 2 Process of Recovery – The recovery tier focuses on the patient’s journey back to a functional status. This includes time to recovery, treatment processes, and all interventions involved to overcome the medical disease or condition. The second tier is where you typically find issues with discomfort, retreatment, short-term complications and errors.
Tier 3 Sustainability of Health (Post Recovery) – The sustainability tier focuses on allowing the patient to live a fully functional life without interruption of recurrences or developments of new medical illnesses.
Source: Porter, Michael. The Strategy That Will Fit Fix Health Care. Harvard Business Review. Dec 2013.
The “Outcome Score” summarizes the measures into one easy-to-use score, making it easy to quickly compare providers in your area. Our measurements are standards-based and focus on a capability, comfort and calm construct.
Q . What are the five star ratings for a Provider?
The five star ratings are a Net Promoter Score (NPS) ranking for each individual provider. The NPS is a composite score of Patient reported Net Promoter Score “How likely would you recommend this provider to a family member, friend or colleague?”
Q . What are the five star ratings for a Hospital?
The five star ratings are a Net Promoter Score (NPS) ranking for each individual Hospital. The NPS is a composite score of Patient reported Net Promoter Score “How likely would you recommend this hospital to a family member, friend or colleague?” The information displayed is a combination of reported to CMS and an internal collected survey question from users.
To learn more, visit CMS Survey of patients’ experiences (HCAHPS) URL:https://www.medicare.gov/hospitalcompare/Data/Overview.html
Q . What is the “Outcome Score” of a hospital?
The “Outcome Score” is an overall rating of a Hospital based on outcome metrics reported to CMS. We report Deaths, Readmissions, Complications and Infections to help you make your own informed decision. Hospitals’ rates are compared to the national rate to determine if hospitals’ performance on these measures is better than the national rate (lower), no different than the national rate, or worse than the national rate (higher). Whether or not the hospital is actually reporting their outcomes drives their overall “Outcome Score”. The “Outcome Score” summarizes these outcome metrics into one easy-to-use score, making it easy to quickly compare hospitals transparency in reporting in your area. Note, we do not accept responsibility for CMS data quality, accuracy or collection methodology.
To learn more, visit CMS measures of complications, deaths & unplanned hospital visits URL:
To learn more about how CMS computes these measures visit URL: https://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx?type=lcd&page=index_local_alpha.asp&from=alphalmrp&letter=S&lmrp_id=30364&lmrp_version=3&basket=lcd:30364:3:Stereotactic+Radiosurgery+(SRS)+and+Stereotactic+Body+Radiation+Therapy+(SBRT):MAC+-+Part+A:First+Coast+Service+Options%25257C%25257C+Inc.+(09101)
Q . Do you have “Outcome Scores” on VA hospitals?
As of June 2017, No! The Veterans Health Administration (VHA) collaborated with the Centers for Medicare & Medicaid Services (CMS) to present information to consumers about the quality and safety of health care in VHA. VHA has approximately 50 percent of Veterans enrolled in the healthcare system who are eligible for Medicare and, therefore, have some choice in how and where they receive inpatient services. VHA has adopted healthcare transparency as a strategy to enhance public trust and to help Veterans make informed choices about their health care. However, the VA reports their information separately and uses different measurements, which means we cannot compare “apples to apples” between VA and community hospitals. In the interest of fairness, all hospitals should be judged against the same performance measurements.
Q . Do all providers report their outcomes to CMS?
No. Clinicians and group practices can choose to participate in different quality activities, including various Centers for Medicare & Medicaid Services (CMS) quality programs. These are voluntary activities that show clinicians and group practices are committed to providing you quality care. There are many reasons why clinicians and group practices may not participate in CMS quality activities even though they're committed to providing you high quality health care. While participation in CMS quality activities shows a commitment to quality care, participation alone does not mean the clinician provides quality care. Showing a commitment to quality is the first step in providing quality care. Source medicare.gov
Q . Has GAO found anything wrong with how they reimburse providers?
Yes, in June 2017, the Government Accountability Office (GAO) 17-551 HOSPITAL VALUE- BASED PURCHASING described steps CMS should take to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses.
“The Hospital Value-based Purchasing (HVBP) program aims to improve quality of care and efficiency by creating financial incentives for about 3,000 participating hospitals. From fiscal years 2013 through 2017, performance on quality and efficiency measures varied by hospital type. Safety net hospitals— those that serve a high proportion of low-income patients—generally scored lower in quality compared to all participating hospitals. In contrast, small rural and small urban hospitals—those with 100 or fewer acute care beds—scored higher on efficiency compared to all hospitals.
“So that lower quality hospitals do not receive bonuses, GAO recommends that CMS revise (1) the methodology used to calculate total performance scores and (2) its method of accounting for missing quality scores. In its written comments, HHS indicated that it would consider revising these two methodologies.”
Q . How can I share specific provider or hospital information with a loved one or friend?
Either use the social media tools found the results pages to share on FaceBook, Twitter, Pinterest etc., or simply copy the URL for a specific provider’s or hospital’s page and place it in an email or text message. Share the information so we can create transparency and a consumer-driven healthcare system!
In 2007, Dr. Regina Herzlinger said it best, “Soaring healthcare costs that cripple our global competitiveness, uneven quality of care, 46-plus millions uninsured, and Medicare and Medicaid programs whose deficit threatens our children’s economic welfare – who can best solve these mind-numbing problems? The government? A technocratic elite? Status quo insurers and hospitals? Or you and me?”
Q . How up-to-date is your data?
Our proprietary data and CMS is updated in real-time from medicare.gov and other various databases we utilize. When they update their information, we do too. Note, we are not responsible for CMS or other data sources quality, accuracy or collection methodology.
Q . Should I use this information if an emergency arises?
NO! In case of emergency, go to the closest hospital or call 911. This information is NOT intended for navigating medical emergencies, but for informational purposes only. You take full responsibility for your own healthcare choices and do so at your own risk. If an emergency call 911.
Q . Where does the U.S. Government get their data from?
Per Medicare.gov: “Hospitals report data to the Centers for Medicare & Medicaid Services, the federal agency that runs the Medicare program, through the Hospital Inpatient Quality Reporting (IQR) Program and the Hospital Outpatient Quality Reporting (OQR) Program.”
Q . If data comes from Medicare.gov - does it only include data of Medicare patients?
Data that comes from all patients at listed hospitals: process of care, healthcare-associated infection (HAI), and HCAHPS Survey Data that comes from Medicare patients only: Mortality, readmission, complications, PSI-90, and imaging efficiency measures.
Q . I’m having trouble using your website or mobile application. Who can I contact for support?
Contact firstname.lastname@example.org for all website or mobile app related issues.
Q . What research indicates Patients need and will use a website like My Doctor Knows?
•87% of U.S. adults use the internet
• 111,615,000 U.S. adults have looked for a specific health outcome online
•31% of cell phone owners, and 52% of smartphone owners, have used their phone to look up health or medical information.
•19% of smartphone owners have downloaded an app specifically to track or manage health.
•7 in 10 U.S. adults have tracked a health indicator for themselves or for someone else. Of those, 34% share their health tracking records or notes with another person or group.
•3-4% of internet users have posted their experiences with health care service providers or treatments.
•26% of internet users have read or watched some else’s experience about health or medical issues in the last 12 months.
•26% of online health seekers say they have been asked to pay for access to something they wanted to see online (just 2% say they did so).
Source: Pew Research Center for Healthcare 2012-2014
Q. What are other countries actively doing to achieve value-based healthcare standards?
Many countries are exploring new healthcare delivery strategies to prioritize value-based outcomes over volume. Governments are implementing new reimbursement methods, such as bundled payments vs. fee for service in the United States. These new policies and payment methods tied to individual patient outcomes will have a profound impact on the healthcare industry.
Q. Why is measuring health outcomes important?
Outcomes should be measured by the patient’s medical condition or primary care patient segment, and not by procedure or intervention. The outcome should reflect the full cycle of care for the patient’s condition. Each medical condition will have its own set of outcome measures and vary according to the patient population. An outcome dimension may involve one or more specific measures and depend on the range of available treatments, complications, and duration of care.
Measuring clinical outcomes is central to assessing the quality of care. Outcomes measures can be very useful in quality improvement programs, by pointing out the areas in which intervention could improve care.[i] “Outcomes should be measured for each medical condition covering the full cycle of care, including acute care, related complications, rehabilitation, and recurrences. It is the overall results that matter, not the outcome of an individual intervention or specialty (too narrow), or a single visit or care episode (too short). For example, if a surgical procedure is performed perfectly but a patient’s subsequent rehabilitation fails, the outcome is poor.”[ii]
[i] Selecting Health Outcome Measures for Clinical Quality Measurement. Agency for Healthcare Research and Quality. June 2015. Available at: https://www.qualitymeasures.ahrq.gov/tutorial/HealthOutcomeMeasure.aspx
[ii] Porter. ME. Measuring Health Outcomes: The Outcome Hierarchy. (2010). N Engl J Med 2010; 363:2477-81 (10.1056/NEJMp1011024) Appendix 2
Q. How will implementing a value-based approach improve outcomes while also reducing costs?
Unfortunately, most current outcome measurements focus on the immediate results of a particular treatment for a patient condition rather that the overall success of the full lifecycle of care. The preponderance of hospital measurements tends to be process driven versus outcome driven and less centered on the dimensions most important to the patient. A value-based approach toward improving outcomes replaces an old mindset that simple process improvement changes or staff/service cutbacks will somehow deliver value. Using the Value Realization FrameworkÓ for total organizational alignment with a focus on patient conditions brings accurate cost and value measurement into healthcare delivery. To learn more check out Value Management in Healthcare: How to Establish a Value Management Office to Support Value-Based Outcomes in Healthcare (HIMSS Book Series)
Q. What is the impact of My Doctor Knows?
The overarching goal for healthcare providers, as well as for every other stakeholder, must be to improve value – and satisfaction - for patients. Here we defined value as delivering the health outcomes that matter most to patients at the lowest possible cost. To that end, applications that empower patients, clinicians, and payers will influence the future healthcare delivery landscape in three distinct ways:
· Patients will choose providers based on outcome value scores.
· Providers will leverage data to make targeted improvements and learn.
· Payers will measure ROI and direct patients to high-value providers.
Absent a value-based approach toward achieving desired outcomes, patients, clinicians and payers will suffer the consequences of inefficient and poor quality of care, dissatisfaction, and increased medical costs. Sitting on the sidelines is not an option, help us bring transparency to healthcare.
HIPAA* is the Health Insurance Portability and Accountability Act. You can review this important law’s provisions and your rights and obligations at www.hhs.gov/hipaa/index.html/