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Earlier, I posted a note on the issues of privacy versus transparency. Obviously, others are wrestling through the same issues as well; for example, this New York Times article highlights the federal government's decision to make physician discipline and malpractice actions information less available. This is obviously a step in the wrong direction for those of us who want patients to make informed decisions.

Earlier, I posted a note on the issues of privacy versus transparency. Obviously, others are wrestling through the same issues as well; for example, this New York Times article highlights the federal government's decision to make physician discipline and malpractice actions information less available. This is obviously a step in the wrong direction for those of us who want patients to make informed decisions.

A history of disciplinary and malpractice actions is medically relevant. To say that doctors' privacy trumps patient empowerment would be akin to saying that companies should have a right to redact their profiles from sites like Better Business Bureau. Even if people were to successfully argue that a corporation is meaningfully different as a service provider than an individual, the government should still at least make disciplinary and malpractice actions available at the company (or practice) level.

What puzzles me is that an administration that campaigned on the promise of transparency threatened a reporter with civil fines for trying to uncover a story. Instead of working to make information more readily available, the government is "reviewing the public use file and may change it to further assure confidentiality." Really? What happened to patients' interests?

This is a quick note for those who are planning on attending this year's Health 2.0 conference in San Francisco: I'll be presenting a short demonstration of our Clinician Finder product in the Provider Search for Consumers panel on Monday (the full agenda is here).

If you'd like to meet up, let me know via the Contact form.

This is a quick note for those who are planning on attending this year's Health 2.0 conference in San Francisco: I'll be presenting a short demonstration of our Clinician Finder product in the Provider Search for Consumers panel on Monday (the full agenda is here).

If you'd like to meet up, let me know via the Contact form.

I think hospitals are the antithesis of roller coasters. People with heart conditions and pregnant women should be admitted, and you want the ride to be over as soon as possible.

But how can you find the hospital that will give you the least bumpy ride?

I think hospitals are the antithesis of roller coasters. People with heart conditions and pregnant women should be admitted, and you want the ride to be over as soon as possible.

But how can you find the hospital that will give you the least bumpy ride?

We realize that you may not have much control over where you go because of insurance constraints or because the imminency of your condition forces you to go to the closest hospital, irrespective of its quality. However, if you are ever able to plan your hospital visit in advance, you can now use DocSpot to help you make your decision.

To get started, click on the "find a hospital" tab in the upper right corner of the homepage. You can sort your options by hospital size, type, or whether or not a hospital is affiliated with a medical school. You can also search for accredited hospitals on DocSpot. Accreditation is important because it means that the hospital has passed basic quality inspections.

Since patients enjoy reading anecdotal reviews, like for our doctor search, we have pulled together star ratings from multiple websites. We have also included Medicare's survey data of patient experience; some of you may find these results more helpful than online reviews. For one, they are broken down into specific aspects of hospital care, such as pain control, quietness, and cleanliness. Secondly, the survey ratings generally average feedback from hundreds of patients, many more than you would find on most review websites.

As always, take patient ratings with a grain of salt. Often reviews don't accurately reflect the actual performance of a hospital as far as outcomes, like readmissions and mortality. Readmission rates are important because they let you know how many people had to return to the hospital because of complications or worsening symptoms. Often re-hospitalizations are preventable, especially for Medicare patients, who may readmitted due to poor discharge planning.

There are many dimensions to hospital quality, and the literature on how to properly evaluate hospitals is contantly changing. In the coming months, we hope to add more data sources to help you make the better decisions about hospitals, including hospital infection rates, out-of-pocket costs for common procedures, and a richer array of accepted insurance plans. Please leave us feedback, and let us know how we can make finding a hospital even easier for you!

There's an interesting blog entry where Dr. Liu comments on Dr. Ofri's lament of being measured solely on clinical outcomes and not on interpersonal skills. Dr. Liu uses his own practice as a positive data point that it is indeed possible to have great clinical outcomes and great patient satisfaction.

There's an interesting blog entry where Dr. Liu comments on Dr. Ofri's lament of being measured solely on clinical outcomes and not on interpersonal skills. Dr. Liu uses his own practice as a positive data point that it is indeed possible to have great clinical outcomes and great patient satisfaction.

What's interesting to me is that health care institutions sit on mounds of performance data (both clinical outcomes and patient satisfaction scores), but essentially none of that information is made available to patients when they select a doctor. You can argue about the meaningfulness of such outcome data, but the fact that health care institutions themselves measure their doctors' performance suggest that at the very least, the institutions believe there is some merit to the measures. If so, why not release it to the patients so they can factor it into their decisions regarding whom to visit for care? I suspect that responses would likely fall into one of the following camps:

1) "Patients won't know how to interpret the data or won't care" -- this might be true, but I think it's a tremendous stretch to say that all patients will be unable to interpret the data or won't care. Why not release the data so that patients who do care can make better decisions?

2) "We monitor our physician performance internally and ensure that all physicians are up to our standards" -- in other words, "don't worry, we've got you covered." Like the first response, this response is awash with paternalism. The institution assumes that its standards are at least as high as the patients' standards. Additionally, since there are multiple dimensions, not releasing the data deprives patients of the opportunity to select a doctor according to his own preferences. For example, one patient might be willing to put up with lower clinical quality indicators in favor of better patient satisfaction scores; or the reverse might be true. Either way, patients don't get the opportunity to choose for themselves.

3) "This is an issue of doctor privacy" -- this is probably the strongest response, and the argument is that doctor privacy trumps patient interest in his own health. Maybe. It's a little like a politician saying "there's no need to looking at my voting record -- I've got your interests covered." I'd bet that if the economics change such that disclosing performance numbers brings in significantly more revenue, health care institutions will suddenly find a new love for transparency, claiming it as a cherished virtue all along.

Who will be on the patient's side?

As you know, our primary focus at DocSpot has been to connect you with individual health care providers. This week, I had hoped to unveil a new service that would allow you to search for hospitals, but the final touch-ups have taken me longer than I expected. Sometimes the smallest segments of a product can take the longest amount of time. Such is the nature of development.

As you know, our primary focus at DocSpot has been to connect you with individual health care providers. This week, I had hoped to unveil a new service that would allow you to search for hospitals, but the final touch-ups have taken me longer than I expected. Sometimes the smallest segments of a product can take the longest amount of time. Such is the nature of development.

In this case, I discovered that one of our sources of data was not as tidy as we had thought. Since we deal with publicly available data, we don't expect everything to be nicely sorted and packaged for us. That's what our specialized "robots" are for. However, there are certain times when the data proves to be incorrigible, and we must either reject it as a primary source or dispose of it altogether.

I had relatively high expectations for Medicare's "Providers of Service" list; albeit publicly available, it is not free. And at first glance, it seemed polished and straightforward to integrate. Then when I ran some diagnostics, I met with the worst nightmare of any engineer tasked with data management: duplicates. Multiple hospitals with the same address and same name - but different data. I had no idea which profile was correct, and the data's documentation didn't give me any indication of how to resolve the issue, let alone mention possible redundancies.

So, as engineers are wont to do, I started looking for patterns. I found a reference number that might link one duplicate to the next, a date which seemed to indicate when the profile was last updated, a code that suggested a hospital had been shut down, a category that appeared to single out duplicate entries. In the end, the relationships seemed too arbitrary, and I hadn't even rooted out all the redundancies. One pair, in particular - two profiles for Broughton Hospital, in North Carolina - deigned to mock my efforts: differing by only one or two data points, they matched on every single metric I used to differentiate between duplicate profiles.

After almost giving up on this rich source of data, I finally discovered another Medicare file (on a completely different section of their website) that identifies the unique entries in the problematic source. Problem solved. The question remains - will there be yet another set of finishing touches? Time will tell - such is the nature of product development. In the meanwhile, keep checking our blog for updates, and let us know what you would like to see in our upcoming hospital product.