In March 2013, author Steven Brill published an article called “Bitter Pill” in Time magazine. Based on CMS data covering approximately 100 conditions, the article asked, for instance, why a colonoscopy costs $300 in one clinic and $3,000 in another.
Now New York State is taking that effort at transparency a step further. In two weeks, it plans to publish on its web site hospital charge data for 1,400 conditions in the State of New York. “This is going to matter,” stresses Nirav Shah, M.D., M.P.H., New York State Commissioner of Health. “In a high-deductible health plan world, having access to hospital charges matters. Because a $4,000 C-section at Montefiore Medical Center vs. a $12,000 one at Mt. Sinai — and these are real numbers — for the same quality outcomes, make a big difference in your choices, and the type of care you are going to request. Those are the types of things we now have an opportunity to release on our web site, and we have an aggressive schedule beyond that as well.”
At the 2013 Health Datapalooza in Washington, D.C., the Health Data Consortium (HDC) gave the inaugural Health Data Liberator Award to Dr. Shah. The award recognized the New York State Department of Health’s efforts to make health data publicly available. In March 2013, New York launched the first state open data web site devoted exclusively to health, called Health.Data.NY.gov.
On Oct. 30, HDC hosted a webinar with Dr. Shah to go into some detail about the benefits and challenges of opening up public data sets. By making health data available, New York is providing opportunities for data users and developers to create mash-ups of national and New York State health data, a model that other states have since followed.
Shah said one of his agency’s goals is to release as much high-value data as possible to reduce friction in the healthcare ecosystem.
“How much will consumers use this initially? Probably not much,” Shah said. But there will be a dozen or more news stories about it. It will shine a light on the problem and hospitals will have to respond, he said.
The same is true with sepsis deaths in hospitals, he added. He believes that just mandating reporting and publication of the data will reduce the number of sepsis deaths by 8,000 per year. “We are hot-spotting,” he said. “We know we have systemic problems for which no one is accountable.” Just highlighting the problems can draw resources toward solving them.
He noted that the open data initiative has already proven valuable to state employees as well. His department traditionally received 5,000 to 7,000 Freedom of Information Act requests per year, which are time-consuming to respond to. “We took the ones that were most requested, and made the data publicly available, and it eliminated 700 requests right away. We were able to reduce FTEs and be more responsive.”
Shah said that beyond any technical issues, work needs to be done around cultural change among executives and agencies. “People say that releasing the data may make us look bad. But that is the point,” he added. We have to willing to fix things where the data shows deficiencies. That is a conscious choice you have to make.”
Besides sponsoring the annual Health Datapalooza in Washington, D.C., the Health Data Consortium is launching a series of webinars and is hosting a full-day meeting in Chicago on Friday, Nov. 8, called “Putting Health Data to Work in Our States and Communities.”