Only 5% of hospitals or health systems have more than one transparency program such as posting some treatment pricing or physician reviews online that can be directly accessed by patients.

Patient transparency on issues ranging from posting more medical treatment costs online to getting patients even access to their medical information is getting a lot of buzz around the healthcare industry these days.

But buzz is pretty much all that’s happening at many institutions, according to new data from the NEJM Catalyst Insights Council, a unit of the New England Journal of Medicine Group that conducts a monthly survey on various healthcare topics. In fact a March survey nearly 800 health system executives, NEJM found that only 17% of respondents rated the level of patient transparency at their institution as “mature,” compared with 50% that rated it “somewhat mature” and 33% that rated patient transparency “not mature at all.”

“At first blush, one might find this bleak, but the truth is that patient-facing transparency efforts are still in the early stages,” writes chief medical quality officer Robert Pendleton, chief medical quality officer at University of Utah Hospitals and Clinics. “Following the stages of the diffusion of innovation, the health care industry is already past the few innovators and well along the way toward an early majority of maturity, and actively pushing forward in applying transparency.”

Patient transparency takes many forms, the survey says. 88% of respondents say transparency means sharing of quality/outcomes with patients of specific services/procedures offered, followed by sharing of cost-of-care information with patients for services/procedures offered (85%), open sharing of health information such as electronic medical records (62%) and sharing of patient experience performance with patients (61%). “The top tier of responses—cited by more than 80% of respondents—is for clinical quality and cost-of-care elements. The second tier of responses focuses on the patient experience,” according to the survey.

Lack of data and shared data are the roadblocks healthcare administrators and clinicians as the top reasons patient transparency isn’t farther along, says the NEJM Catalyst survey. “Data limitations such as collecting, risk adjusting and disseminating data are cited as the top barrier to successful implementation of transparency initiatives (by just over half of respondents,” writes NEJM clinical editors Namita Seth Mohta. “These inadequacies tie into concerns about adverse selection (cherry picking) and clinician burnout because providers may not trust the data and often lack the ability to fully control or influence many of the metrics that we currently collect.”


Improving patient care is the reason 51% of survey respondents cite for implementing more patient transparency followed by transparency contributes to overall improved outcomes and lower healthcare cost and helps change provider behaviors to improve care delivery processes at 47%, respectively.

Yet even though health system managers agree more patient transparency is necessary, progress to build up transparency will be slow in coming, the survey says. For example only 5% of hospitals or health systems have more than one transparency program in place such as posting some treatment pricing or online physician reviews that can be directly accessed by patients or individual providers. In comparison, 62% have at least one patient transparency program in place and 33% have none.

“The responses clearly indicate much need for improvement in transparency,” the survey says.