Technology and Transparency: Empowering Patients and Clinicians to Improve Health Care Value
Authors: Suzanne Delbanco, Tom Delbanco
Journal: Annals of Internal Medicine (2018)

Ideas and Opinions17 April 2018Technology and Transparency: Empowering Patients and Clinicians to Improve Health Care ValueSuzanne Delbanco, PhD and Tom Delbanco, MDSuzanne Delbanco, PhDCatalyst for Payment Reform, Berkeley, California (S.D.)Search for more papers by this author and Tom Delbanco, MDBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (T.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-3269 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail While patients and clinicians confront daunting uncertainties regarding health care, arguments rage about quality, costs, and how to improve the lives of both those who seek and those who provide care. In light of rapidly evolving health information technologies, we anticipate that widespread societal movement toward greater transparency will spur important advances. Consider the following scenario:Mr. J is 64 years old, and his osteoarthritic knee pain and accompanying disabilities are becoming unbearable. On his laptop, he reviews his personal health record containing the notes and plans that he, his primary care doctor, and 2 consultants developed during and after ...References1. Roberts ET, Zaslavsky AM, McWilliams JM. The value-based payment modifier: program outcomes and implications for disparities. Ann Intern Med. 2017. [PMID: 29181511]. doi:10.7326/M17-1740 LinkGoogle Scholar2. Burstin H. The journey to electronic performance measurement [Editorial]. Ann Intern Med. 2013;158:131-2. [PMID: 23318313]. doi:10.7326/0003-4819-158-2-201301150-00009 LinkGoogle Scholar3. Song Z, Rose S, Chernew ME, Safran DG. Lower- versus higher-income populations in the alternative quality contract: improved quality and similar spending. Health Aff (Millwood). 2017;36:74-82. [PMID: 28069849] doi:10.1377/hlthaff.2016.0682 CrossrefMedlineGoogle Scholar4. Integrated Healthcare Association. Value Based Pay for Performance: Results & Highlights Measurement Year 2016. Oakland: Integrated Healthcare Association; 2017. Accessed at www.iha.org/sites/default/files/files/page/general_session_-_vbp4p_updates.pdf on 30 January 2018. Google Scholar5. Emanuel EJ, Ubel PA, Kessler JB, Meyer G, Muller RW, Navathe AS, et al. Using behavioral economics to design physician incentives that deliver high-value care. Ann Intern Med. 2016;164:114-9. [PMID: 26595370]. doi:10.7326/M15-1330 LinkGoogle Scholar6. Arterburn D, Wellman R, Westbrook E, Rutter C, Ross T, McCulloch D, et al. Introducing decision aids at Group Health was linked to sharply lower hip and knee surgery rates and costs. Health Aff (Millwood). 2012;31:2094-104. [PMID: 22949460] doi:10.1377/hlthaff.2011.0686 CrossrefMedlineGoogle Scholar7. NH HealthCost. Compare health costs & quality of care in New Hampshire. 2018. Accessed at http://nhhealthcost.nh.gov on 30 January 2018. Google Scholar8. Sinsky C, Colligan L, Li L, Prgomet M, Reynolds S, Goeders L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016; 165:753-60. [PMID: 27595430]. doi:10.7326/M16-0961 LinkGoogle Scholar9. Mafi JN, Gerard M, Chimowitz H, Anselmo M, Delbanco T, Walker J. Patients contributing to their doctors' notes: insights from expert interviews. Ann Intern Med. 2018;168:302-5. [PMID: 29132154]. doi:10.7326/M17-0583 LinkGoogle Scholar10. Walker J, Meltsner M, Delbanco T. US experience with doctors and patients sharing clinical notes. BMJ. 2015;350:g7785. [PMID: 25670182] doi:10.1136/bmj.g7785 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Catalyst for Payment Reform, Berkeley, California (S.D.)Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (T.D.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3269.Corresponding Author: Tom Delbanco, MD, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Rabb 117, Boston, MA 02215; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. S. Delbanco: Catalyst for Payment Reform, 2120 University Avenue, Berkeley, CA 94704.Dr. T. Delbanco: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Rabb 117, Boston, MA 02215.Author Contributions: Conception and design: S. Delbanco, T. Delbanco.Analysis and interpretation of the data: S. Delbanco, T. Delbanco.Drafting of the article: S. Delbanco, T. Delbanco.Critical revision for important intellectual content: S. Delbanco, T. Delbanco.Final approval of the article: S. Delbanco, T. Delbanco.Administrative, technical, or logistic support: T. Delbanco.Collection and assembly of data: S. Delbanco, T. Delbanco.This article was published at Annals.org on 6 March 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHarnessing the Consumer MovementCatherine M. DesRoches, DrPH and Liz Salmi 17 April 2018Volume 168, Issue 8Page: 585-586KeywordsDatabasesElectronic medical recordsForecastingHealth careHealth information technologyKneesMotivationPatientsSurgeonsSurgery ePublished: 6 March 2018 Issue Published: 17 April 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...