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Let’s Get Transparent About the New ONC Initiative

by Greg Carey, Technology Standards and Policy Manager

The name “athenahealth,” printed startlingly in red, standing out among a sea of other healthcare vendor names that are nicely colored green, is not normally a good thing. As a company, we strive to be ahead of the curve, to top the list—to be, if you will, the greenest of all the names.

This is not one of those times.

On the first of June, the Office of the National Coordinator (ONC) for Health Information Technology, part of the US Department of Human and Health Services, announced a new transparency initiative targeted at all healthcare IT vendors. The initiative requests that vendors share pricing, usability, and limitation information of their products, in an effort to aggregate a reference sheet for potential users—primarily, for healthcare providers. With this compiled list, healthcare providers are able to discover and compare participating vendors and what they offer.  Or are they?

The notion is wonderful; it is a noble goal to clean up healthcare’s rough edges and sift through its weeds. But this goal is not easily achieved, and ONC’s strategy is not perfect. For an initiative designed to provide clarity, it is notably opaque. Riddled with confusing language, pioneered by a federal quasi-regulator, and aimed at synthesizing the various goals, models, and products of widely differing vendors—something isn’t adding up.

Partially due to these reasons, athenahealth has declined to participate. The issue is that ONC’s proposed measure asks us to clarify and make easily accessible information that we have long made utterly clear and accessible. Moreover, the pledge asks us to recodify that information from our company’s standards to ONC’s. We have always prioritized transparency with our customers, and our refusal to acquiesce to ONC’s voluntary measure is not at all a reflection of how athenahealth intends to move forward in interactions with consumers. Prioritizing transparency will continue to be at the forefront of our mission. Informed discussions drive the marketplace, and we will maintain active participation in these discussions. If this weren’t the case, and we didn’t have the sort of transparency that we do, perhaps we would feel differently about this entire initiative. Perhaps we would agree to participate in ONC’s initiative. Perhaps our name would be in green.

But we don’t feel differently, and have thus declined ONC’s invitation. We applaud ONC’s goal of increased transparency within healthcare, but we’re also proud of our ability to achieve it on our own. We don’t need a checkmark or a governmental pat on the back to prove our point, so long as our relationship with the marketplace and its consumers continues to be an unambiguous and honest one. Attestation does not equal accountability—what happens outside of this public list, between vendor and client, is what truly measures transparency.

Let’s be clear: athenahealth’s refusal to participate isn’t really an issue at all. Transparency is, and always has been, absolutely necessary for a vendor in order to ensure success within an undeniably muddied system. As we recently told Becker’s Hospital Review, without product and price transparency, it would be difficult for a vendor to find itself any sort of market. A self-regulating mechanism, the healthcare marketplace functions by the interaction between vendors and consumers—that sort of transparency is necessarily organic and shouldn’t be the result of federal intervention. Yet here the government seems to be carving out a pedestal for itself in an industry space where there simply shouldn’t be one.

As an industry, we must confront the reality that agreeing to ONC’s transparency initiative, or any other voluntary federal measure that inhibits a free marketplace, is submitting to regulation by loyalty pledge. To agree to such a measure, and to attest to continue to be transparent, is simply redundant for athenahealth and is not in the best interest of our clients. We’d rather not tailor the way we currently communicate with our clients on the basis of a quasi-official federal suggestion.

So, if you find yourself scrolling through the list of vendors and their commitments to this initiative, and you see our name stamped in red digital ink, do not be alarmed. We embrace our noncompliance with this voluntary initiative. We are happy with the space we occupy, one dedicated to direct communication with clients and open invitations to concerns of consumers, our own unfiltered and transparent corner of the marketplace. 

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