By Evan Falchuk
If a web site touted misleading health care information, you’d hope the government would do something about it. But what do you do when the government is the one feeding the public bad information?
Last week, the Obama administration launched the new Healthcare.gov.
It’s mostly an on-line insurance shopping site. It is very much a federal government version of sites like eHealthInsurance.com or Massachsetts’ HealthConnector site, which have been around for years. So when HHS Secretary Kathleen Sebelius, in announcing the new site, claims it gives consumers “unprecedented transparency” into the health care marketplace, you should wonder what she means.
But that’s not the big problem with this site.
Right there in the middle of the top of the page is a big tab that says “Compare Care Quality.” If you click on it, you are taken to an “interactive web tool” that claims to show you “44 quality measures” about hospitals. The site says it will help you compare the quality of care hospitals provide.
I decided to look at hospitals in the area where I live, Boston, Massachusetts. It gives you a list of hospitals in your area, and gives you options to compare hospitals based on medical conditions and surgical procedures.
I decided to compare the Brigham and Women’s Hospital in Boston with the Hallmark Health System in Melrose. If you don’t know these two facilities, the Brigham is a Harvard teaching hospital, justifiably world-renowned in many areas of care. The Hallmark Health System is a network of community hospitals, which I suspect most people even in the Boston area aren’t familiar with.
I decided to run my search based on the idea that I was trying to help someone with breast cancer.
The first problem I ran into is this: they don’t have any data on breast cancer. Actually, they don’t have data for cancer at all. The only things they can tell you about are chest pain, heart attack, heart failure, chronic lung disease, pneumonia and diabetes in adults.
How about a search on surgical procedures? Nothing again. My only option is a “general” search.
Ok, well, I guess it’s a work in progress. So how do the two hospitals stack up?
They give you a few ways to compare, but the one that I think most pertinent is “outcome of care.” If you click on that you see that “outcomes” are based purely on how many people died who had a heart attack, heart failure, or pneumonia. So much for my “general” search (and my cancer patient).
So how do they stack up? You can’t tell the difference. Both hospitals are “no better than the national average” in two categories, and “better than the national average” in one.
You get more detailed information – but it only makes things worse.
For example, in death rates for heart attack, the Brigham and the Hallmark hospitals are both “no better than the national average.” Is that good? It turns out that that “above average” hospitals are as rare as four leaf clovers – out of 4,569 hospitals in their data set, only 95 are better than average (2%). Only forty-five (1%) are worse than average. Two-thousand seven hundred and forty four (60%) were “no better than the national average.”
The other 1,685? They don’t have enough data to figure that out. The smart money says they’re all “average,” too.
Maybe if I just compare them to other Massachusetts hospitals I will get a clearer picture. Nope. Out of 65 hospitals measured in Massachusetts, only nine were better than the national average (14%). Fifty-one were average (78%), and zero – zero - were worse than average (5 didn’t have enough data).
I know health care in Massachusetts is good -but not a single hospital is below average?
It is deeply misleading to consumers to suggest they inform their health care decisions in any way shape or form by this kind of data. It’s not that the data is incomplete – it is – it’s that even within the data you can’t tell the difference between a major teaching hospital and a local community hospital.
I’d love to know if the people presenting this as a useful tool for consumers think it really is. It leaves you knowing less about the differences among hospitals than before you use it. That’s shameful because the site encourages people facing medical situations to use it for that purpose. The only thing it is going to do for sure is heighten patients’ anxiety, and make their decision-making more difficult.