Are patients using the data to shop for doctors, hospitals or health plans?
I see transparency working at three levels, and in some ways, the patient level is weakest. The strongest lever is learning — that if I can find out who has the lowest mortality rate for cardiac surgery or the shortest waiting times, I can go learn from them. The second level (on which transparency) works is the super-egos of those who give the care. They all want to do well and not want to see themselves at bottom of some list of performers and that is a tremendously powerful lever. I do not believe the fundamental dynamic through which improvement occurs through transparency is the public making its choices. I don’t think that’s the way it happens. Q: What do you think of the transparency efforts in the House and Senate health reform bills — including publishing hospital infection rates and making public and penalizing hospitals with the highest readmission rates? A: Being aware of variation in infection rates is going to stir the super-egos of the system quite a bit and I hope the
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