When it came to putting physician ratings and reviews online, Nebraska Medicine is doing it their way.

Nebraska Medicine launched an unusually detailed doctor reviews and ratings system on Nebraskamed.com on July 10, asking consumers to rate 10 aspects of their doctors’ visits, including how much time the provider spent at the session and how well they explained medications.

“Healthcare is a word-of-mouth business and online social media moves quickly,” says Nebraska Medicine chief experience officer Chad Brough. “We didn’t want the feedback on our physicians to be entirely on Yelp where there may be only a handful of comments or the physician was unaware of a comment and the comment didn’t receive a response.”

That’s a common problem hospitals and healthcare systems face now that so many consumers air their likes and dislikes about visits to the doctor online on popular ratings and review sites such as Yelp.com., HealthGrades.com, Vitals.com and others. 84% of patients now use online reviews to evaluate physicians and 77% of patients use online reviews as their first step in finding a new doctor, according to a recent survey of 1,438 consumers from SoftwareAdvice.com.

One of the state’s biggest healthcare systems with 809 beds at its two hospitals, more than 1,000 physicians and 40 specialty and primary care clinics in Omaha and surrounding areas, Nebraska Medicine wanted to be proactive rather than reactive when it came to putting up online physician ratings.

Even before rolling out its ratings program, the health system already gathered plenty of feedback from patients about doctors from about 25,000 mail and e-mail surveys yearly. But Nebraska Medicine made online physician reviews a priority because it didn’t want to fall behind on moving more of its patient engagement and satisfaction program to the web, says executive director of patient experience Chaise Camp. “We wanted to be in a better position to be in front of the consumer,” Camp says. “Consumers routinely rate and review their experience on Amazon.com and now they are doing it in healthcare.”

It can be a two year process to develop and implement an online physician ratings and reviews program for a big hospital network, but Nebraska Medicine was able to roll out a program in about 12 months, Brough says. “We had good physician buy-in from the start,” he says.

Nebraska Medicine worked with Connect Healthcare, a Decatur, Ga., developer of healthcare provider communications product and services, to launch online doctor ratings. Overall Nebraska Medicine has about 1,000 affiliated physicians including 400 doctors that work directly for the health system. When the program launched earlier this month it did so with ratings and reviews on 270 physicians across 25 specialties.

The online ratings and reviews launched with a minimum of 30 comments per physician and a total of about 25,000 comments gathered from patient feedback surveys. That includes comments from the Hospital Consumer Assessment of Healthcare Providers and Systems survey hospitals fill out each year for the Centers for Medicare and Medicaid Services.

In hospitals, putting in place the procedures, policies and technology to publish doctor ratings and reviews can be a challenge. The process can involve more than a dozen internal hospital departments, including legal and compliance to make sure online comments adhere to provisions of patient privacy law under HIPAA. Many times physicians also are reluctant to participate for a variety of reasons including issues dealing with legal concerns and patient confidentiality.

But Nebraska Medicine says physician participation and buy-in wasn’t a major issue. “We told doctors ‘you want to manage the process’ on this,” Camp says. “Doing it this way lets you manage your reputation.”

Patients at Nebraska Medicine, which annually treats more than 24,000 patients internally and has more than 480,000 encounters in outpatient settings including diagnostic testing, radiology and specialty clinics, seem to like their doctors. On a star scale of 1 to 5, the average for the 270 physicians rated on Nebraskamed.com is 4.7, Brough says. “In the first week we had ratings and reviews, a patient came to a new doctor visit with a print of out of that doctor’s comments and says that reason they picked that doctor,” Camp says. “We thought that was pretty cool.”

On many hospital sites the rankings only show the 1-5 star rating. But Nebraska Medicine breaks out its 1-5 ratings for 10 office visit details including:

• Amount of time the care provider spent with you
• Care provider’s efforts to include you in decisions about your treatment
• Concern the care provider showed for your questions or worries
• Degree to which care provider talked with you using words you could understand
• Explanations the care provider gave you about your problem or condition
• Friendliness/courtesy of the care provider
• Information the care provider gave you about medications (if any)
• Instructions the care provider gave you about follow-up care (if any)
• Likelihood of your recommending this care provider to others
• Your confidence in this care provider

“We are going to show the patient everything that is there—warts and all,” Camp says.

The online doctor ratings and reviews are driven in large measure by how patients and consumers use Google. “Our research indicated that when people search healthcare services, 76% of the searches are seeking providers (rather than facilities) and 60% of the searches occur on mobile devices,” Brough says. “We want searchers to find our providers in the search engine without needing to find our ‘find-a-doctor’ page on the health system web page.”

Nebraska Medicine has an active base of patients that use its One Chart patient portal. About 81,000 users have an active account.

As consumers go online in bigger numbers to manage their health and wellness, Nebraska Medicine will continue to add more digital and mobile tools, such as the new ratings and reviews system. “Like many health systems, we are exploring a direct-to-consumer strategy,” Brough says. “Nebraska Medicine is in the midst of a large-scale patient access transformation.”