The Journey to Transparency: Overcoming the Challenges of Transparency Q&A - Binary Fountain

December 29, 2016

The Journey to Transparency: Overcoming the Challenges of Transparency Q&A

By: Zargham Ghani

In our last Journey to Transparency blog post, we spoke with two of our Binary Fountain experts, Senior Onboarding Specialist Carrie Gardner and Senior Account Manager Kait Phillips, about what they’re seeing in the marketplace firsthand and why some healthcare organizations have been slow to adopt transparency.

In Part II, Carrie and Kait take us a little deeper into the process and tell us just how to overcome the challenges of transparency. They also give us the best practices for implementing and managing a transparency solution such as Binary Fountain’s Binary Star Ratings.

Q: What are the best practices for publishing patient comments on the organization’s website?

Carrie Gardner: We definitely recommend for clients to openly display comments. Now and then we’ll speak to a client who thinks that they only want to show ratings on their provider pages, but it is certainly more valuable to the consumer to see the comments and ratings.

We suggest providing some information about where the ratings and comments are coming from and noting that the organization is committed to full transparency. We also have some defaults and recommendations around comments per page for page load performance. We typically suggest 20 comments per page, so that the page doesn’t fail to load due to time-out issues. However, the overall style and set up of the webpages is really up to the client and their personal preference.

Q. Say a practice has a large amount of survey data. What are the best practices for reviewing and managing that data? 

CG: Well, the initial review period can take some time. Generally speaking, if it’s a large organization with a lot of data, and they’re utilizing the centralized model with two or three people at most reviewing the comments, they can still get through their historical data within a month. Going forward, we receive data from most survey providers at least monthly, if not more frequently. After the initial review of historical data, it’s best to go in and review new comments on a monthly basis.

It can sound daunting at first, but once we’ve discussed the review method and the organization has set up a review process, people generally feel a lot more comfortable with it. It’s really not as time consuming as one might think!

Q. What advice would you give someone who is looking to adopt transparency? How should they prepare? 

Kait Phillips: Be prepared to sift through a substantial amount of historical survey data in preparation for going live. I recommend doing a soft launch to give doctors a chance to see what will be published online and also to reassure them that most of the feedback is usually positive. A soft launch enables all the active providers access to the tool itself, allowing them to go in at a read-only level in order to see what kind of comments and ratings are being imported.

In addition, we suggest following best practice guidelines for comment approval criteria – which messages will be approved and which won’t. A transparent policy will prevent confusion and will usually assuage any apprehension on behalf of the physicians.

Q. What are some of the pitfalls you often see clients running into? 

KP: The biggest pitfall I’ve seen clients run into is trying to get around transparency. We always take the time to educate new clients on our best practices and recommendations up front, but some do decide to implement their own guidelines concerning comments. However, the star ratings will always go through and can’t be edited. It is very rare for any client to completely reject all comments that are negative as long as they are not offensive or inappropriate.

Q. What is the best approach you have seen by a client when implementing transparency?

CG: Usually the smoothest implementations are with clients that have already been engaging with their providers about the initiative. For example, one new client I’ve been speaking with started sending providers a report of their ratings and comments using the Press Ganey reporting tool. They’re involving their providers ahead of going live on their external site, which is always a more successful approach. As a result, their implementation process has been smoother.

Another thing I’ve seen is clients that understand that there are different roles people in their organization need to play in implementing transparency and that they need a certain amount of time to commit to it. When there is one person who really drives the initiative and makes it known to the people who are going to be taking on a lot of the implementation tasks, everything tends to run a lot smoother. And when those people feel invested in the initiative and have the time to accommodate it, it’s definitely going to be a more successful approach, as opposed to someone just trying to wing it or do it with limited time.

Q. Who in each organization needs to be involved to make sure this initiative is successful?

KP: The web developer implements the stars and places them in the correct place on the site while the heads of the digital marketing team are usually the main points of contact on the client side.

CG: Patient experience groups are also involved. There might also be a main provider champion who is often a part of the review committee as well. However, most often it is a Director of Clinical Data, Director of Patient Experience or a Digital Marketing Director that is heavily involved on the client side. On the call, we also need whoever will be responsible for implementing the ratings and comments on their provider pages, or their web services contact.

Q. What are the best practices for displaying star ratings? How do your clients calculate star ratings?

CG: Star ratings are calculated by taking the mean average of a set number of questions. In terms of the questions that are used for that average, the best practice is to use those that are specific to the care provider. Depending on the survey, those questions will be different, but in general there’s a care provider section or there are specific CG-CAHPS queries related to each care provider. So, we recommend always using a mean average of the questions in the survey that are specific to the physician such as their communication style, bedside manner, etc.

In terms of visual display, the most common approach is to show the average individual rating of the care provider with patient ratings listed below. The second most common method offers a little more. It also displays the overall rating and comments with individual ratings, but it displays an average of the individual questions that make up that overall rating, too.

Q. What is the baseline number of reviews a physician should have before ratings are displayed next to their profile and why?

CG: We always recommend a minimum of 30 ratings over 365 days for our clients. The default is 30 ratings, but this is configurable in the system. We recommend a minimum of 30 ratings because that number has been shown to be statistically relevant. It’s generally a magic number where you won’t see as much movement in the star ratings overtime. For example, if you were only displaying about 20 ratings and comments and you received one awful survey, it could greatly impact the overall rating on your page. However, if you’re using the minimum of 30 ratings, one additional negative survey is not as likely to have a great sway in your overall valuation.

Transparency is vital for both healthcare providers and consumers. It helps build trust with prospective patients, improve acquisition and strengthen brand image. It is an essential step to create a better consumer and patient experience.

Binary Star Ratings, helps healthcare organizations leverage existing surveys and turn responses into reviews and ratings for publishing onto online physician directory pages, helping clients demonstrate their commitment to transparency.

Got questions for Carrie and Kait? Send your questions to

About the Author

Zargham Ghani
Engagement Manager

Zargham help healthcare organizations better understand their healthcare consumer challenges and needs, in order to efficiently manage and improve patient satisfaction.

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