What makes some consumer purchasing guides successful? Can lessons learned from successful guides be applied to tools to support people making decisions about their healthcare?

People’s use of healthcare decision tools lags behind expectations. In response, CFAH gathered insights from top industry leaders and analysts about popular consumer guides outside the healthcare sector. These insights, along with data from research and trade publications, generated lessons that healthcare stakeholders can apply to improve the development and dissemination of health care decision aids and tools.

CFAH, the Changes in Health Care Financing and Organization program office of the Robert Wood Johnson Foundation, the California Health Care Foundation, and the Foundation for Informed Medical Decision Making provided financial and technical support for this project.

Background: Americans use a variety of purchasing guides to help make choices about the cars they drive, the colleges and universities they send their children to and the mutual funds in which they invest. Such guides have successfully helped many consumers consider a wide array of features when they face many options and have limited time to do their own analyses.

In the healthcare sector, both commercial and non-profit groups have developed tools to help people make informed decisions about health plans, hospitals, long-term care facilities, doctors, and medical treatments. But these tools are not being used as widely and frequently as hoped by their developers, even as consumer-driven healthcare advances.

The Research: This research is designed to help healthcare groups improve their approaches to tool development, marketing, and promotion with the aim of increasing consumers’ use of decision tools to make informed choices about various aspects of their health care.

CFAH first obtained insights on widely used purchasing guides in non-healthcare sectors of the consumer economy. Discussions with corporate officials and industry analysts focused on factors in the development, marketing, dissemination and use of purchasing guides that resulted in widespread use. The resulting products include detailed case studies of four successful consumer guides: Consumer Reports: Car Buying Guide; eBay; U.S. News & World Report: America’s Best Colleges, and the FDA’s federally mandated Nutrition Facts Panels.

In the second project phase, a panel of five leaders with expertise in the development and dissemination of decision support tools for healthcare examined the four case studies to extract lessons that developers and marketers of healthcare-related tools could apply to increase their use.

The panel of reviewers included Margaret Holmes-Rovner, PhD: Professor of Health Services Research in the Department of Medicine, Michigan State University; David Kanouse, PhD: Senior Behavioral Scientist at RAND Corporation; Stephen Parente, PhD, MPH: Academic Director, Medical Industry Leadership Institute, Associate Professor School of Finance at the Carlson School of Management, University of Minnesota; Dale Shaller, MPA: Shaller Consulting; Shoshanna Sofaer, PhD: Professor of Health Care Policy, Baruch College, CUNY. Their individual commentaries are included in the materials.

You may download the key findings from our Executive Summary, the Lessons Learned and the Advancing Healthcare Decision Aids documents. The full Getting Tools Used document is also available to download.

Through this project, we have gained a deep appreciation of the complex factors at play, a clearer idea of how to apply appropriate techniques to analyze and assess the problems facing developers of decision aids, and new insights into how to deal with the untidy uncertainties of real people making life altering choices about their health and health care.

CFAH is an independent non-profit organization that receives funding from the Annenberg Foundation, the W.K. Kellogg Foundation and others.


  1. Foreword by Jessie Gruman
  2. Executive Summary
  3. Introduction: 21st Century Marketplace
  4. Case Study Research Framework
  5. Case Studies
    1. Consumer Reports: Car Buying Guide
    2. eBay.com
    3. FDA Nutrition Fact Panels
    4. U.S. News & World Report: America's Best Colleges
  6. Case Study Commentaries
    1. Margaret Holmes-Rovner
    2. David E. Kanouse
    3. Stephen Parente
    4. Dale Shaller
    5. Shoshanna Sofaer
  7. Lessons Learned: Key Variables of Success
  8. Advancing Healthcare Decision Aids
  9. Research Team Bios
  10. Acknowledgements

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