While some organizations and advocates say the long-anticipated arrival of the Centers for Medicare and Medicaid’s Open Payments is an important milestone in healthcare transparency, the reaction around the web was thoroughly mixed, chiefly calling out the system’s clunkiness that was tough to navigate even for healthcare experts.
Part of the ACA’s Sunshine Act, Open Payments is revealing a stream of previously unreleased data on payments made to physicians and academic hospitals from pharma, device manufacturers and other companies within healthcare. The first release showed about $3.5 billion in payments to physicians and hospitals, while yesterday it was noted that more than $27 billion was spent by the pharmaceutical industry on marketing drugs to physicians in 2012.
Ed Silverman, writing in the Wall Street Journal’s Pharmalot, says “navigating the site can be — to put it mildly — challenging.” He goes on to quote Paul Thacker, a fellow at the Safra Ethics Center at Harvard University who helped draft the legislation with Sen. Chuck Grassley (R-Iowa) that led to Open Payments.
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“I tried to go through and couldn’t figure it out. It was tough,” Thacker told the WSJ. “It’s so complicated that it’s almost useless. It looks like data bombing and I don’t think the average American will find it useful. It’s disappointing.”
Even the experts over at ProPublica found it challenging, despite having data and healthcare experts analyze the database.
“If the federal government’s new Open Payments website were a consumer product, it would be returned to the manufacturer for a full refund,” Charles Ornstein writes. “As a health care journalist at ProPublica, I’m reasonably competent at analyzing data, plus I’m lucky to have another data reporter and a news application developer helping me. Still, it took us hours just to upload the data onto our servers so that we could dig into it.”
In addition, concerns remain over the accuracy of the data itself, Modern Healthcare reports:
“Citing concerns about the accuracy of the data, the American Medical Association has urged the CMS to delay publication of the database. Other groups including the Advanced Medical Technology Association and the Pharmaceutical Research and Manufacturers of America have expressed concerns about whether the database would provide adequate context to enable consumers to understand what the payments represent and how they can promote healthcare research and better quality of care,” Reporter Jaimy Lee writes.
But supporters maintain the release of the data is an important milestone, even if the initial launch is clunky.
Consumer Union, the advocacy division of Consumer Reports, hailed the release:
“Consumers Union strongly supports the Sunshine Act and the release of this data,” Lisa Swirsky, senior policy analyst, said in a statement. “Making this information available will illuminate and hopefully root out potential conflicts of interest between doctors and the drug and device makers. Consumers deserve to know the financial relationships among these players.”
Swirsky goes on to acknowledge that delivery of the data is challenging, though she said it would likely improve over time.
“While reported setbacks with some of the data are disappointing, it is important to keep things in perspective. Data quality improves over time when stakeholders and the public have a chance to review it and address issues,” she said.
The Pew Charitable Trust is another advocate, calling the release “a significant accomplishment.”
The AMA is among the staunchest critics of the effort, outlining a host of concerns in a letter earlier this summer to CMS, among them inaccurate and misleading data that could have a “chilling effect” on physician autonomy.
“There are widespread concerns that the implementation of this new system for data collection … will not be ready and will likely lead to the release of inaccurate, misleading and false information,” the letter said.
It’s perhaps worth noting that similar complaints about the usability of Healthcare.gov were just as rampant in the early stages, but that it eventually got better over time. Whether that holds true again this year, however, remains to be seen. Granted, the release of financial data on doctors isn’t as vital for most average people as obtaining health insurance, but it seems like a worthy effort if it can be placed within the proper context.
Time will tell if the consumer agrees or not.
