Why does management think that clinicians should not have access to information regarding cost and reimbursement of their healthcare operations? It seems that this has been a prevailing attitude among administrators who believe that nurses and therapists get too hung up on the numbers and should not be concerned about these financial matters; just attend to patient care and leave these financial matters to the administrative leadership. One manager recently expressed her concerns about getting clinicians involved, saying it may actually detract from patient care, ”We don’t disclose the actual dollar amount to staff as they seem to only focus on the financial aspect,” she said.
I am wondering how these practices will play out in the future of accountable care. Transparency of cost information is a significant driver in the effort to lower care costs and improve efficiencies of care delivery. Understanding the relationships between cost and payment would seem to be a rationale step to making better decisions about effectiveness and efficiency for everyone involved in the process.
Electronic clinical records and data systems are providing sources of information about the care delivery process previously unavailable. There is a growing awareness that access to provider information may actually increase the knowledge base to all, including patients.
In a recent study appearing in theAnnals of Internal Medicine, Patient Interest in Sharing Personal Health Record Information, the practice of holding clinical notes beyond patient access was challenged and offered a conclusion that “existing and evolving PHR systems should explore secure mechanisms for shared PHR access to improve information exchange among patients and the multiple persons involved in their healthcare.”
“Patients want to look into their doctor’s black box, and many doctors are a bit nervous about what they’ll find,” said one of the researchers from Beth Israel Deaconess said in a news release. The researcher continued, “but I expect that over time everyone will benefit enormously from such transparency.”
As the electronic record of patient care releases more insight into the cost and effectiveness of the care delivery process, all involved will need to adjust their historical perspectives of who should see what; the new accountability will demand it.