1. Morse, Kate J. RN, CCRN, CRNP, MSN

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As a healthcare provider and consumer, I approach the concept of transparency from two perspectives. Organizations should be transparent with their current workforce outcomes, including employee satisfaction and all its variables. Being an informed potential employee makes you a better representative of that organization in the future.

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When you are in the role of healthcare consumer, your focus should be on patient quality and outcomes. Being able to link quality patient outcomes with financial data is important, as consumers assume a greater financial responsibility for healthcare costs. We need to educate our patients to understand this new responsibility.


The concept of blind trust in the healthcare provider or institution is no longer an accepted truth. The tide is changing with education and consumer advocacy. Transparency in healthcare is now a national priority. In August 2006, President Bush signed an Executive Order that directed federal agencies that administer or sponsor federal health insurance programs to:


* increase transparency in pricing. This directs federal agencies to share with beneficiaries information about prices paid to healthcare providers for procedures.


* increase transparency in quality. This directs federal agencies to share with beneficiaries information on the quality of services provided by doctors, hospitals, and other healthcare providers.


* encourage adoption of health information technology (IT) standards. This directs federal agencies to use improved health IT systems to facilitate the rapid exchange of health information.


* provide options that promote quality and efficiency in healthcare. This directs federal agencies to develop and identify approaches that facilitate high quality and efficient care.1



This decision sets forth a mandate for all healthcare agencies and healthcare personnel to be forthright with costs and patient outcomes. As the financial responsibility for healthcare moves to healthcare consumers, they should be able to accurately compare an organization's or practitioner's quality outcomes and costs. Having accurate information will allow them to make the most informed decisions.


Currently, there is not always a direct correlation between cost and outcomes. Being able to navigate this morass of information will be challenging for healthcare consumers. The Internet will be a primary source of this information. As with any available information, users will have to discern which sources of information are accurate and reliable.


Nurses will play a significant role in aiding healthcare consumers to understand this potential explosion of information, as well as being on the front lines of collecting and submitting the most accurate outcomes in their organizations. We must understand the importance of reporting patient outcomes and the increased burden of data collection. Supporting this process and looking for IT solutions to reduce nursing time will be increasingly important in the future. Nurses should be the leaders in this change-not only will this be important to our professional future, but also our personal futures as healthcare consumers.


Kate J. Morse, RN, CCRN, CRNP, MSN


Editor-in-Chief, Assistant Clinical Professor, Acute Care Nurse Practitioner Tract Coordinator Critical Care Nurse Practitioner, Chester County Hospital West Chester, Pa.




1. Fact sheet: health care transparency: empowering consumers to save on quality care. Available at: Accessed March 21, 2008. [Context Link]