Public Reporting of Hospital Infection Rates: Ranking the States on Report and Website Content, Credibility, and Usability

BACKGROUND:  Health-care associated infections (“HAIs”) kill about 100,000 people annually; most are preventable, but many hospitals have not aggressively addressed the problem.  In response, twenty-five states and the U.S. Department of Health and Human Services require public reporting of hospital infection rates for at least some types of infections, and other states and private entities are implementing such reporting.  The websites and related reports vary widely in ease of access, ease of use, usefulness of information, timeliness of updates, and credibility. 

METHODS:  We report on work in progress, in which we assess the quality and suitability of different state websites and reports for different target audiences (ordinary consumers; physicians, and infection control professionals) and the extent to which they meet best practices for online communication, including Stanford’s “Fogg” Guidelines for Web Credibility and user-friendliness metrics developed by other researchers.

RESULTS:  We find wide variation in quality, and substantial correlation between measures of website credibility and user-friendliness.  We also focus on three states (California, Pennsylvania and Washington) which have made substantial changes in their HAI public reports, websites, or both since they began disclosing HAI rates.  Indeed, Washington has made two sets of substantial changes to its HAI public reports/websites.  Does change mean progress?  Sadly, as we show, no.  

CONCLUSIONS:   Our analysis suggests that the “one website (and report format) fits all users” model may not work well in delivering complex, technical information to users with widely varying needs and sophistication.  We identify ways to improve usability, usefulness, and tailoring for information to different target audiences.