Presented by the Sauder School of Business MIS Division:
Friday, April 1, 2011 9:30am – 11:00am
Henry Angus Room 296
No RSVP Required
Professor Ritu Agarwal
Ritu Agarwal
Professor and Dean’s Chair of Information Systems
Director, Center for Health Information and Decision Systems
Robert H. Smith School of Business
University of Maryland
Abstract
Healthcare is a critical part of the economy of the United States, accounting for more than one of every six dollars of spending in 2009, yet, despite the extraordinary expenditure, the US healthcare system suffers from significant deficiencies with respect to both healthcare quality and cost. There is substantial consensus that the digital transformation of healthcare through broad and deep use of health information technology (HIT) across the healthcare ecosystem, in conjunction with other complementary changes, can address some of the systemic problems confronting healthcare. Over the past five years we have conducted multiple studies focused on various aspects of the digitization of healthcare. In this talk I will provide an overview of this stream of research, followed by a detailed discussion of one specific study focused on the Health 2.0 phenomenon.
There is broad consensus among policy makers and consumer groups that greater transparency in healthcare will improve the quality and reduce the costs of care delivery. However, until recently consumers had limited avenues for discerning the quality of physicians, even though there is evidence that the variation of quality across individual physicians can be substantial (Gawande 2002). Fueled by the wide spread availability of the Web 2.0 technologies, online physician ratings have begun to gain momentum in recent years, much like the growth of consumer review systems in other domains such as movies and electronics. Evidence also suggests that the physician ratings are being used by patients: 76% of Angie’s list users welcome physician rating information. Further, 61% of US adults have looked online for health information, and among them 24% have consulted rankings or reviews online of physicians or other providers (PEW, 2009). However, despite the increasing popularity of online physician ratings, there is substantial controversy surrounding their value as a signal of physician quality. Professional societies such as the American Medical Association and some state governments have expressed concerns that these ratings merely reflect unhappy patients’ opinions and may ruin physicians’ reputation. Because the online ratings are generated by anonymous users voluntarily, there is a likelihood of substantial bias associated with this self-selection process, which can be detrimental to the informational value of these online ratings for consumers’ choice processes.
This study provides an in-depth analysis of the information value of the online physician ratings. We focus on the two selection biases that online ratings might suffer from: bias in the selection of physicians being rated (where we explore which of the “bad mouthing” versus “sound of silence” assumptions holds), and bias arising from the people who contribute the ratings. Online ratings are posted by anonymous users, and it is not clear whether these users are representative of the population of patients. Previous studies have indicated that people are more likely to talk about extreme experiences. If the ratings are motivated by patients who are extremely happy or unhappy with a physician, then we should expect large variation/dispersion in online opinions compared to the population evaluation towards a physician.
We use a unique data set compiled from three distinct sources: physician ratings from RateMDs.com, physician profiles from state medical boards, and offline surveys of physician quality conducted by health insurance companies in three US metro areas: Denver, Kansas City, and Memphis. Econometric analyses support the existence of the “sound of silence,” moderate correlation between online ratings and population opinion, and provide evidence of the utility of online opinions in discerning low quality physicians.
