Monday, February 24, 2014
Guest Blogger Associate Dean and Professor Elizabeth Pendo: Consumer Ratings of Accessible Health Care Offices and Facilities
Learning where people with disabilities seek care, as well as the physical, equipment, and attitudinal barriers they face there, is important. Section 4302 of the Affordable Care Act (ACA) requires the Department of Health and Human Services (HHS) to identify locations where individuals with disabilities access primary, acute, and long-term care, the number of providers with accessible facilities and equipment, and the number of employees trained to care for patients with disabilities. Unfortunately, there has been little progress on this requirement.
Surveys and interviews with patients with disabilities should play a role in this effort. Last week, I shared a study that used a secret shopper method to quantify the lack of access to subspecialists for people with mobility impairments. Other studies of health care offices and facilities, summarized in my prior work here and here, have documented similar barriers, including architectural obstacles and a lack of accessible medical and diagnostic equipment. The studies also reveal a lack of awareness and knowledge about the American with Disabilities Act’s (ADA) requirement of equal access in the health care setting. Accordingly, HHS should not rely on surveys of providers alone, and instead should incorporate other methods, such as surveys and interviews of patients and independent, on-site inspections.
What should patients with disabilities and their families do while we wait for this to be done? Is there a role for consumer ratings of accessibility of health care offices and facilities? Although consumer ratings of physicians is a contentious issue, a research letter published in the Journal of the American Medical Association (JAMA) earlier this month found that patients turn to rating websites such as Vitals and Healthgrades to gather information about physicians, just as they do with other products and services. Would – and should – people with disabilities do the same for accessibility of health care offices and facilities?
One platform for such review already exists: AXS Map. Designed by a New York filmmaker and wheelchair user, Jason DeSilva, AXS Map is a customer review website and mobile app that allows people to review businesses on their accessibility to people with disabilities and to share that information with other users. It allows users to review businesses on Google Maps, including medical and health care related businesses, on a one to five star rating system, with special attention given to attributes such as accessible parking, ramps and entryways, restrooms, and information in Braille. Reviewers can also leave comments.
I did a search for “medical” businesses nearby the law school’s downtown location, which generated reviewable listings for physicians, hospitals, dentists, chiropractors, acupuncturists, pharmacies, home care agencies, rehabilitation centers, and medical spas, among others. I had to broaden my search to find any reviews.
Services such as AXS Map are not designed to measure compliance with the ADA or the ACA in terms of architectural or programmatic access, and would not replace the data gathering required by the ACA. It shares all of the advantages and drawbacks of other consumer rating websites. But it could serve as a tool for people to share information about the accessibility of medical and health care related businesses in their communities.
-Guest Blogger Associate Dean and Professor Elizabeth Pendo