Blog | Friday, April 15, 2016

Transparency 2.0


I had the opportunity recently to speak about our practice of posting patient comments and survey scores on our physicians' web pages. The conference at which I presented was devoted to “transparency and innovation” and it became clear to me that making patient satisfaction scores public, while innovative today, will be universal pretty soon. The same forces that convinced us to go this far—rising consumerism among care-seekers, the ubiquity of ratings and information for other goods and services, and the evolution of payment models away from fee-for-service—will compel us to provide more and more information to patients and potential patients.

What might that look like? Here are a few possibilities.

Operational transparency. We provide information to patients about the care that others have experienced “in the exam room” with their physicians, but not about other things that matter to patients, like how easy it is to get an appointment, or how long the average wait in the office is, or how quickly we provide lab results. It is now not uncommon now to see highway billboards indicating average wait times in local emergency departments. I think we will soon be expected to provide similar information for our physician offices.

Price transparency. As more and more people face higher out of pocket costs because of high-deductible health plans and limited (or no) out of network benefits, consumer price-sensitivity will continue to rise. Obviously, acting on prices requires knowing the prices. Even if patients may be reluctant to “shop by price” I believe they will choose price certainty over price uncertainty, and providers will be pushed to provide more and better information about the actual costs that patients face.

Outcome transparency. There was a big splash recently when CMS and a bunch of private payers announced (another) effort to harmonize their quality measures in order to reduce the burden of collection and reporting on providers. Nearly all of those measures are about processes of care, rather than about how patients actually fare with the care they receive. That seems to me a little like continuing to work on perfecting the horse and buggy instead of acknowledging that patients want to drive a car. I agree with Porter and Lee, who (again) outlined the need to move to measuring outcomes of care, and especially those outcomes that matter most to patients, such as functional recovery or freedom from pain and disability.

I think that organizations that take the lead in providing information like this will win big. What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.