Hospital CEO Salaries Tied to Health IT Use and Patient Satisfaction Rates But Not to Patient Outcomes

When you talk about the people who enter the health care system, what do you call them? Are they patients or are they clients? Perhaps they are customers. Or maybe consumers. No matter what you call them, their opinion of your services matters to you.

The concept of patient satisfaction has been around for decades. When I was a nursing assistant in the mid-90s, I remember the displeasure many nurses expressed when they were told they had to follow a “script” during patient interactions. They felt as professionals they should be trusted by the hospital administration to interact appropriately with their patients.

Since then, emphasis on patient satisfaction has only grown. Patient satisfaction rates are now measured and scrutinized. In 2006, The Centers for Medicare and Medicaid Services launched its Hospital Consumer Assessment of  Healthcare Providers and Systems survey to help patients compare hospitals. Now, as part of the Affordable Care Act, results of those surveys will be a factor in determining how much facilities receive in Medicare reimbursements.

Patient satisfaction rates also influence the salaries of hospital CEOs, a recent study published by Journal of the American Medical Association has found. Higher patient satisfaction scores equaled higher salaries. Interestingly, the study also found that  “hospitals with high levels of advanced technologic capabilities compensated their CEOs $135 862 more than did hospitals with low levels of technology.”  However, mortality rates, readmission rates and community benefit did not influence CEO salaries.

Does this mean it’s better to have a happy patient than a healthy — albeit grumpy — patient? And how does HIT fit into all of this?

The first place I went to find the answers to these questions was the same place I go to when I need the answer to the question: Where are my car keys? — my husband. I told him about the study results and his response was, “That’s interesting.” I agreed with him but then asked him, “Yeah, but what does it mean?”

His answer was perception. You’ve no doubt heard the saying “Perception is reality” and this definitely holds true in health care. I thought back to the time my friend took her son to the hospital for what should have been routine surgery. She emailed me because she was upset, rightfully so, by the experience. On her list of complaints was that the nurse had called the physician from her cellphone. My friend thought it was unprofessional to be using a personal cellphone for work. I explained that most likely the hospital provided its nurses with the cellphones during their shifts so they could easily reach other health care providers. What she perceived as “wrong” was actually standard practice.

My husband’s theory is that health IT helps boost patients’ perceptions, rightly or wrongly, that they are getting good care. Do you want to go to a “state-of-the-art” facility or to one that is still using equipment from the 1980s? I recently was shown a supply room with all the nursing essentials stacked on silver shelves. I had to catch my breath and not blurt out “Where is the OmniCell? How can you function without one?”

To me an OmniCell represented a tech-savvy way to keep track of supplies. It represented efficiency and accountability.  I had no data to help me know if an OmniCell truly improved patient care, but it was my perception that it did. Patients may feel the same way. Who wouldn’t assume that cutting edge technology would lead to better care?

But technology can only go so far and the rest is up to us humans. The newest model MRI may produce the most clear and easy to read scans, but if the health care provider doesn’t interpret them correctly or doesn’t communicate the information to the patient in a clear way then you’re probably not going to get the best patient outcome.

I’d love to see studies that delve deeper into this issue. Take out the factor of CEO salary completely and then look at how HIT affects patient outcomes and take a separate look at how it affects patient satisfaction. What we find might help us improve both patient satisfaction and patient outcomes and lead us to the ultimate goal of healthy, happy patients.

On a side note, my last post focused on the glitches in the newly launched Health Insurance Marketplace website.

John Green of the vlogbrothers also tested out the website and shows you his results in this video. The results may surprise you!

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Jennifer Thew, RN, MSJ

Jennifer Thew, RN, MSJ, is a registered nurse and journalist who has covered healthcare issues and how they relate to the nursing profession. She began her nursing career as a neuroscience nurse at Rush University Medical Center in Chicago and then transitioned to journalism after receiving a degree from Roosevelt University in Chicago. She has edited and written numerous articles on a wide range of nursing and healthcare topics like Accountable Care Organizations, evidence-based practice and telehealth.

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