Transparency in Healthcare Leads to Trust and Improved Outcomes
The national emphasis on value-based healthcare and metrics based on improved outcomes is putting a renewed focus on the issue of transparency. Transparency comes in the form of information to patients, such as the services providers offer, the cost of those services and the quality of the services.
In 2006, The Commonwealth Fund published an article titled, "Transparency in Healthcare: The Time Has Come." In it, the authors stated: Transparency and better public information on cost and quality are essential for three reasons: 1) to help providers improve by benchmarking their performance against others; 2) to encourage private insurers and public programs to reward quality and efficiency; and 3) to help patients make informed choices about their care.
Six years later, our nation is still facing a healthcare system in a state of flux, making it even more critical to stay focused on The Commonwealth Fund’s directive and for stakeholders to keep the lines of trust and communication open with patients. In his New York Times article, "New System for Patients to Report Medical Mistakes," Robert Pear reports on a new consumer reporting system for patient safety. In the article, it states that "Federal officials say that medical mistakes often go unreported, and that patients have potentially useful information that could expose reasons for drug mix-ups, surgery on the wrong body part, radiation overdoses and myriad other problems that cause injuries, infections and tens of thousands of deaths each year."
Should the Agency for Healthcare Research and Quality gain approval from the White House on this project, consumers will be able to complete a questionnaire to report medical mistakes and unsafe practices by doctors, hospitals, pharmacists and others who provide treatment. What will then bring transparency full circle is for the healthcare organizations to take the feedback to heart and make the necessary improvements to avoid future problems.
Dr. Marty Makary of Johns Hopkins Hospital recently wrote a piece in the Wall Street Journal addressing the issue of transparency and offering solutions to counter the sting of medical mistakes with five ways to make healthcare safer. I found these to be simple yet brilliant and am delighted to see that many are already in practice around the country. One is that every hospital should have an online informational "dashboard" that includes its rates for infection, readmission, surgical complications and "never event" errors (mistakes that should never occur, like leaving a surgical sponge inside a patient). Another is giving patients online access to their doctors’ notes. A third is videotaping physician procedures — measuring the time and assigning a quality score.
Transparency is also gaining momentum with payers. Recently, UnitedHealth Group launched a website that allows members to compare doctors’ and hospitals’ contracted rates for more than 100 common procedures. Members receive information on the total cost and out-of-pocket costs for multiple treatment alternatives. In a poll conducted by Modern Healthcare this summer, 53% of 1,787 respondents said payers are reimbursing providers based on value, instead of volume. An additional 10% of respondents expect to make the shift within a year. When patients receive the right information to make good healthcare decisions, they also see the value of the care they are receiving.
As we work to improve our healthcare system, we find that transparency is important and reveals itself in many forms. It is about providing resources that are easy to access, keeping the lines of communication open between patient and providers, as well as between providers and payers, and making it easy for patients to get engaged in their health and wellness. Transparency is about encouraging responsibility from the provider, payer and the patient, getting care that is valuable, and improving outcomes, which is where healthcare is ultimately headed.
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