Digital HCAHPS Improves Response Rates: Collecting patient experience data is critical for better health outcomes, yet organizations struggle to accurately collect this information because traditional surveying and screening tools are unable to adapt to the unique needs of respondents, resulting in biases. Furthermore, the inability to recognize individual cultural requirements results in incomplete and inaccurate data. Even with the known limitations, organizations rely on available patient satisfaction data, even if unreliable, to identify opportunities for improved care and retention rates and receive reimbursement payments from CMS (Centers for Medicaid Services). HCAHPS, the Hospital Consumer Assessment of Healthcare Providers and Systems survey, is the industry-standard for collecting experience data from patients in the general care setting. For hospitals, the survey is so critical to improving care delivery that it is the only patient experience survey approved for Medicare reimbursement programs. Unfortunately, HCAHPS surveys lack digital empathy and as a result, are providing unreliable and inaccurate data.
Design and delivery impact data-fidelity for HCAHPS surveys.
While universally used for assessing patient experience, HCAHPS® surveys still struggle to collect a representative data set. Delivery and design methods of the survey limit response rates from different demographic groups, leading to non-response bias. By failing to capture data from diverse populations, organizations miss critical information and without the full picture, could make decisions that don’t actually reflect the needs of the whole patient population. Poor data quality and lack of representativeness are thought to be a result of long survey length, confusing question layout, comprehension barriers, and challenges with sampling patients once they leave the clinic or hospital.
Traditionally, HCAHPS surveys are administered via mail and phone. Although recently offered via web and email, this shift hasn’t significantly improved submission numbers. Phoning patients is shown to produce social desirability bias, resulting in poor quality data. While in-person survey distribution is an option, HCAHPS guidelines do not recommend this approach because confidentiality can be compromised and selection bias is common. Currently, all approved methods of HCAHPS administration produce some type of bias or are unable to reach all patients, hindering the ability to produce a representative data set on patient experience.
Digital HCAHPS improves response rates and reduces administrative costs.
Electronic surveys in healthcare improve many aspects of data collection when compared to traditional paper-based surveys. Of greatest value is the ability to ask questions in a more approachable way to the user. With landline use declining, digital HCAHPS is better suited to meet consumers where they spend time communicating— on mobile devices. Designing HCAHPS for web and mobile as well as delivering it to patients on their own devices (with prior consent), allows greater flexibility for them to respond on their own terms. This can reduce selection and social desirability bias, as well as reach a wider population set.
Digital surveys improve patient-reported data collection and also reduce administrative costs. A web-based survey is estimated to cost around $2 per returned survey compared to $10 via traditional methods. Many digital methods also provide additional features such as scoring and analysis, which can save costs associated with data entry and reporting.
User-friendliness matters for both patients and providers when designing a digital HCAHPS.
Design is considered fundamental to successful surveying and factors such as wording, question order, length, and format can impact the response rate and validity for any survey. A user-friendly survey is essential for any data collection, and “user-unfriendliness” has impacted response rates for HCAHPS. With only an estimated 29% of U.S adults having basic literacy skills, a majority of patients surveyed are unable to understand what is being asked. Administrators struggle to collect representative patient experience data because HCAHPS is only accessible to a small portion of the population. Even for individuals who are literate, survey layout and formatting can be challenging to navigate, leading to response error. Various studies have found that for all CAHPS surveys, complex question design and lack of accessibility for diverse populations have impacted both response rates and the reliability of data received.
A user-friendly HCAHPS improves the quality and quantity of patient-reported data. Colors and icons to engage respondents, structured questioning to reduce cognitive overload, and graphic features to improve comprehension, are some of the many ways well-designed, user-friendly digitally empathetic surveys collect more complete and reliable data from patients. For healthcare, these design principles improve HCAHPS results, and in some studies up to 9%,. Literacy is also a critical component when designing a more user-friendly HCAHPS. Not only should instructions and language be simplified to a fifth-grade reading level, but a multilingual digital HCAHPS can also increase response rates. “Technology brings so much to healthcare and can drastically improve the patient experience. Simple things like acknowledging the patient’s response in real-time and providing encouraging messaging keeps the patient engaged to share feedback for HCAHPS surveys”, says Dr. Sandy-Penn Whitehouse.
Digital empathy could improve response rates and the data fidelity of HCAHPS Surveys.
The growing use of digital surveys in healthcare has improved both the experience for patients as well as enhanced the fidelity of patient-reported data tools for clinics and hospitals. For the HCAHPS survey, a digitally empathetic version allows for a more user-friendly interface, multilingual features, and cost-effective delivery methods to patients. This is particularly valuable for the CMS Quality Payment Program and the merit-based incentive payment system (MIPS). As the sole source for providers to capture the patient experience for payment incentives, choosing a digital HCAHPS allows hospitals to reach a wider population and collect better data. With high-fidelity data, a digitally empathetic HCAHPS survey is cost-effective by reducing overhead, streamlining operational workflow, and leading to incentive payments for healthcare systems. When the principles of digital empathy are applied, it is also a better experience for patients. In addition to the benefits of digitizing HCAHPS assessments, it’s also strongly encouraged to incorporate questions about Social Determinants of Health, which are critical to understanding the patient experience and better addressing each patient’s unique needs to reach better health.
Learn more about Tickit and how digital empathy can improve the fidelity of your patient-reported data, or how a digitally empathetic CG-CAHPS improved response rates for UCSF.
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) is an AHRQ program that began in 1995. Its purpose is to advance our scientific understanding of patient experience with health care organizations. CAHPS surveys support healthcare systems to measure patient experience, report on the results, and ultimately use the information to improve the quality of care. With standardized questions and years of data for comparative benchmarking, CAHPS surveys are the gold-standard for measuring experiences with patient safety, care coordination, shared decision-making, and patient engagement. Many types of CAHPS surveys are available and range in specialty from hospitals to nursing homes to health plans.