The rocky rollout of the Sunshine Act’s Open Payments program did not instill confidence in physicians whose names populated its database starting on Sept. 30. Now it is here. And?

User friendly, not

“Frankly, I have had difficulty accessing the data,” says Lisa Goldstein, JD, the regulatory policy counsel for the American College of Cardiology (ACC). “One of our data analysts helped me download. If we are having difficulty I don’t know how patients are able to see anything.”

That the public interface is challenging probably won’t surprise cardiologists and other doctors who wrestled with the physician portal in its prelaunch phase. The Centers for Medicare & Medicaid Services (CMS) promoted Open Payments as a way to add transparency to financial interactions between physicians and industry. Industry personnel would enter the data, which physicians who registered through the portal could then review for accuracy.

According to the agency, 26,000 physicians registered to check submissions under their names.

In an Aug. 3 blog entry, electrophysiologist David E. Mann, MD, wrote of difficulties registering to review his data, which turned out not to be his. His report detailed payments to another physician with the same first and last name. CMS then shut down the site for maintenance and extended the date for physicians and teaching hospitals to review data to Sept. 8.

It announced on Aug. 15 that it fixed the problem and revalidated data, but electrophysiologist Edward J. Schloss, MD, begged to differ. He tweeted that “after CMS reboot of Sunshine data from 3 out of 4 industries disappeared from my report.”

CMS shuttered the site twice again before the launch. It also continued to tweak the public site, with updates in October that it announced would facilitate searches.

What you can do

The ACC encouraged members to review their reports before the site went public, and to continue checking the data to report and correct inaccuracies. Whether they access a cardiologist’s report or not, physicians should still be open with them.

“We encourage (members) to have conversations with their patients about treatment plans, having full and honest conversations about the pros and cons of therapies as well as any potential relationships they might have,” Goldstein says.

Open Payments ultimately may not be that useful. Goldstein points out that each company filed an “assumptions document” that is not public, making it difficult to compare data. “There is so much leeway that the companies had in terms of what they reported and how they reported things,” she says.

Open Payments follows another federal initiative aimed at transparency: a Medicare billing database unveiled in April. Patients who have explored these  databases may benefit from a sit-down with their physicians afterwards.

Critics have lambasted both initiatives for their lack of context. For instance, patients may see that their cardiologist received a seemingly tidy sum from Medicare but they may not understand that the funds supported overhead or included services for a variety of healthcare providers. The result may be confusion, not edification.

“More data isn’t always useful data,” she emphasizes. “There is a difference between the two.”