Boosting sophistication of online provider directories empowers consumers to make better choices

I recently went to a new doctor and noticed he was located in something called the Professional Building. I felt better right away.
      - George Carlin

Time was, a medical professional’s address was a critical factor in how people selected a doctor. No more. Health care intelligence is enabling more informed decisions at a time when consumers are being asked to take greater control over their care.

Consider Joe. At 45 years old, he badly injures his knee playing basketball with friends. At his primary physician’s office, X-rays show a knee fracture that requires treatment by an orthopedic surgeon. None of Joe’s friends have suffered a similar injury or had reason to see this type of specialist, so they are unable make recommendations. His doctor suggests a few names, but Joe is at a loss to assess their qualifications and experience in any meaningful way.

So, Joe does what millions of individuals have done: he turns to his health plan’s online provider directory. Most provider directories can help Joe find specialists in his plan and tell him how to contact them and how far he’ll have to drive to see them. But, before he makes a decision, Joe wants to know more about probable treatment and costs, as well as what affect, if any, his diabetes may have on his condition. Considering these factors, he knows he would feel more comfortable seeing a doctor who has treated patients like him.

Until recently, it would be difficult for someone like Joe to access and assess the information that could inform his decision and allay his concerns.

“With consumers taking a more active role in their health care, their information needs are growing,” according to Kymberly Eide, category director of Directory Solutions at Ingenix. “Health plans that provide innovative search tools can empower consumers to make smarter, data-driven decisions. This gives those health plans a strong competitive advantage, while helping patients get to the right doctor,” she said.

Evolving information to meet consumer needs

For better timeliness and functionality, health plan provider network directories made the jump from a print to an online format more than a decade ago. Today, they are a health plans’ primary interface with members. Provider searches often account for 50 percent to 70 percent of traffic to health plan member portals. However, the level of search functionality among plan directories varies greatly, Eide indicated. “Some plans provide just the basics or send their members out to another Web site in order to search for physicians,” she said. “Other plans offer a more user-friendly provider search environment that is a fully integrated part of the portal where they also offer other plan services.”

Many consumers who are taking charge of their own care and paying a greater share of their health care expenses are looking for more sophisticated search tools and transparency when choosing a provider. In other words, Eide remarked, “members don’t just want to find a doctor in the appropriate specialty within 10 miles of their house; they want to find a doctor that has significant experience treating patients like them for the condition or service they need and who also aligns with their preferences for a doctor.”

A recent Ingenix survey showed that only six percent of members considered location to be the most important factor in choosing a doctor in their plan; 49 percent of those surveyed cited “experience treating my condition” as the most important selection factor. This expectation is logical, Eide noted, and “studies have validated the correlation between outcomes and the frequency a physician treats a particular condition. With any human endeavor, the more often you practice, the better you become.”

Further, because consumers have unique characteristics, such as age, gender and chronic conditions, they seek practitioners who have expertise with those particular characteristics. For example, a parent trying to find a cardiologist for a teenager with an emerging heart problem will probably feel more comfortable with a cardiologist who treats a high percentage of adolescents, and less comfortable with a cardiologist who treats patients who are mostly over the age of 65.

As consumers look to technology to deliver faster, better results in all aspects of their daily lives, it is not surprising that they expect more from health care technology as well. “Twenty years ago, it seemed ridiculous to imagine that the printed directory would go away, but that is where progress has taken the industry,” Eide explained. “In just a short time, it may seem just as ridiculous that we choose a doctor based primarily on that doctor’s distance from our homes or offices.”

Health plans stay competitive by helping consumers

Empowering patients to select the right doctor is a direct member benefit that can pay off for health plans. Greater patient involvement in upfront treatment decisions can contribute to better outcomes and lower costs. Moreover, investing in a more sophisticated, data-rich interface for consumers can differentiate the plan for members and foster continuing business relationships with employer-customers.

“Member preferences for better online provider directory searches are becoming part of employers’ RFPs,” Eide said. “Incumbent plans who offer a high-quality search are likely to retain business. Likewise, a challenger that introduces a better search may win.”

By embracing innovation for their online provider directories, large and small plans alike can better serve their members and improve their health care experiences. “Members want to find doctors that resonate with them as a human being, so helping them to achieve that trusted partnership and improve outcomes certainly is in the best interests of the plan,” according to Eide.

“Plans consistently are asking themselves ‘How do I keep the members I have and build loyalty to the plan?’ and ‘What can I do to set myself apart?’” she continued. “Delivering better online provider directory services to the consumer base is certainly an important option to consider when addressing client retention and new business strategies.”

Implementing new search functionality can be simple

Health plans that want to make the move toward a more advanced, comprehensive and integrated online provider directory do not have to build a new directory infrastructure, make huge investments in internal IT solutions or compile millions of pieces of new data on their providers. Instead, they can turn to Ingenix, which offers Best Match Search technology to personalize the search experience and allow health plan members to search using the criteria that are most important to them.

“Plans are not in the business of developing provider search tools, and they often don’t have the resources necessary to drive broad innovation in this area,” Eide said. “Ingenix has done the heavy lifting, and offers health plans the ability to provide their members with innovative tools without having to invent, design and build the solution themselves.”

Key to a successful online search, she continued, are a robust infrastructure, innovative analytics and the data resources to fuel the system. Best Match Search draws its power from deidentified data from 27 million health care episodes, as well as from data from across the industry. “The Best Match Search tool uses this critical mass of data to enable consumers to find the best match, making reasonable comparisons among providers,” said Eide.

Best Match Search serves up comparative information about providers, including the volume of cases where a provider has treated people matching the patient’s profile, and then outlines the typical approach to treatment. In addition, Best Match Search delivers detailed provider profile information, which can prepare consumers for their first office visit. It presents all of this information in a user-friendly format that makes it easy to read and understand. After narrowing down providers, Best Match Search can generate a side-by-side comparison chart.

By using Best Match Search, which operates under the health plan’s branding and seamlessly integrates into the plan’s member portal, consumers receive a 360-degree view of their upcoming health care experience, Eide noted.

“In this economy and health care environment, basic searches just don’t suffice. If consumers have a positive experience searching for providers on their own terms on a plan’s online provider directory, it strengthens that plan’s position as a trusted advisor,” she said. “When a plan demonstrates added value to consumers by using a service that can improve outcomes, everybody wins.”

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