Why Does the Presentation of Health Care Quality Scores Matter?
Most people have trouble understanding complex information.
Only a small fraction of Americans can easily read complex tables or understand the words typically used in medicine and health. The 2003 National Assessment of Adult Literacy found that only 13 percent of adults were proficient in the kinds of literacy that are critical to understanding and using a comparative quality report.[1]
In addition, nearly all of us suffer from “information overload.” Evidence from cognitive science shows that most people can keep only seven pieces of information, plus or minus two, in mind at once.[2] When we ask people to compare ten physicians to each other on eight different measures of quality, we are giving them more information than they can process. Most people who are confused or overwhelmed by a report will not even try to understand it.
People need help understanding information on health care quality.
Data on health care quality are inherently complex. Consumers must figure out:
- What each measure tells them about the quality of care
- Whether that information is relevant to them.
- How to interpret unfamiliar statistics.
Your decisions about presentation can make it much easier for consumers to perform these mental tasks.
“Evaluable” information leads to more accurate understanding of data.
Research demonstrates clearly the value of making sure people can easily and quickly identify the high and low performers on any quality measure. This concept is called evaluability. Evaluable data displays typically summarize and interpret data for the user, making it easy for consumers to quickly see the best performer.[3] Examples of display choices that improve evaluability include summary measures and labels that indicate high and low performance.
An evaluable data presentation can result in a fourfold increase in the number of people who can accurately interpret comparative quality information.[4] Just as important, the more evaluable the presentation, the more likely it is that those being measured will take action to improve their scores.[5]
[2] Miller GA. The magical number seven, plus or minus two: some limits on our capacity for processing information. Psychol Rev 1994 Apr;101(2):343-52. Available at http://www.musanim.com/miller1956/
[3] Hibbard JH, Peters, E. Supporting informed consumers health care decisions: data presentation approaches that facilitate the use of information in choice.” Annu Rev Public Health 2003(24): 413-33.
[4] Carman K. Improving quality information in a consumer-driven era: Showing differences is crucial to informed consumer choice. Presentation delivered at the 10th National CAHPS User Group Meeting, March 31, 2006. p. 9-11. Available at: http://archive.ahrq.gov/cahps/news-and-events/events/UGM10/DAY2_cd_1_Carman.pdf. Also see: McGee J. Best Practices for Presenting Quality Data. Presentation delivered at the 11th National CAHPS User Group Meeting, CAHPS College, December 3, 2008. Slide 21. Available at: http://archive.ahrq.gov/cahps/news-and-events/events/UGM11/McGee.pdf.
[5] Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Aff (Millwood). 2005 July-Aug;24(4):1150-60.
