Friday, August 15, 2014

Open Payments: Impact on the Noble Profession of Medicine

This blog is a follow up to my previous post dated August 4, 2014 on the Open Payments website related to the Sunshine Act.  In that post, I mentioned the opportunity for physicians to review their own data (as submitted by industry manufacturers) and, if said data were not correct, to formally dispute that data.  However, the website went down after errors were discovered in the submitted data.
Since that time, physicians have been very frustrated that the site was down.  I have had very intelligent faculty members (including a chair of a department) contact me to help with figuring out the process.  Fortunately, the site just opened up yesterday, 8/14/14, and again, physicians could review their own data.  

The Wall Street Journal detailed a piece yesterday mentioning the site as back up and operational, and that the review period to submit disputes would be extended by the number of days that the site was down.  That would make a quick turnaround time for the correction period to be completed before September 30, 2014, the day that that the site was to be officially open to the public.  CMS itself came out with a statement today describing identification of “the problem”, and instituted a system fix to prevent similar errors.  The WSJ followed up today with an updated post highlighting CMS’ position to stick to the September 30, 2014 deadline.

Here is the kicker: CMS will actually withhold approximately 1/3 of the data from the site, due to “intermingled data”, according to a piece earlier today from Charles Ornstein of ProPublica.  “Intermingled data” translated into the fact that physicians were being linked to medical license numbers of NPI numbers that were not theirs.  I cannot fathom how this is possible, as each physician is provided with a unique NPI number.  CMS itself even has an explanation of the NPI number here:  and anyone can look up an individual physician’s NPI number here or here.

If a physician has received no monies from industry, here is what the site will show (in full disclosure, this is the applicable portion of the screenshot from my own log-in):

So where do we go from here?  First, the word needs to get out to physicians that the site is back up, and they should register and review their own data.  The unfortunate problem is that the process is quite complex, and likely takes at least two hours of time to complete all the necessary steps to be able to view the screen above.  A nice explanation of the old timeline and the revised timeline for the dispute period is found in this post

I am all for disclosure and full transparency, but this registration and review process is overly burdensome for physicians, in my opinion.  We need to spend more of our time with our patients, and less time completing administrative duties (translated as “paperwork”, or in today’s current EMR-heavy environment: “computer work”).  The Open Payments system as it currently stands clearly falls into the burdensome “computer work” bucket, and I hope that the process can be simplified in future iterations.  Physicians and other health care providers need to advocate for what makes the profession a noble one: the patient-physician relationship, not time spent trying to comprehend flawed information from a flawed computer system.

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