Transparency is one of the most important words in any communicator’s lexicon. These days, that statement is more poignant than ever in the medical and healthcare space. Making information available to the public is a good thing, especially when it’s easy to access, understandable, and put into the right context for patients. In 2008, Cleveland Clinic was the first hospital in the nation to list our doctors’ relationships with industry on our website.
The healthcare system can be confusing and difficult to navigate. For most people, it’s hard to understand what is both right and wrong with it. This reality came to the forefront very recently.
The Open Payments Program, also known as The Physician Payments Sunshine Act, requires manufacturers of drugs, medical devices, and others that participate in federal healthcare programs to publicly report certain payments and items of value given to physicians and teaching hospitals. The Centers for Medicare & Medicaid Services (CMS) is implementing this program, making the data available to the public. Payments from 2013 were released to the public September 30 and are available at cms.gov/openpayments.
For months leading up to the release, we were trying to plan for internal and external reaction to the information. We didn’t really know what to expect at first, nor did our physicians. We strongly encouraged our doctors to get registered and review their personal data to ensure the information was accurate. From there, they could contest any errors during a window of time before the data was posted publicly. To the best of our ability, we wanted to know what was coming, avoid surprises, and be ready for patient, employee, and media inquiries.
To prepare, we developed a "frequently asked questions" document for our employees, patients, and physicians. The information focused on why doctors interact with industry, the purpose of the Sunshine Act, how to get information about a physician, and what type of information would be reported. We also met with doctors about how to best inform their patients about the newly public information. We developed a media plan and key messages, not fully knowing how this would play out.
The unexpected always challenges even the most thorough of planning. In this case, reporters started calling days before the data became public. Each one called the Sunshine Act something different, which only further confused our PR team as to the nature of the inquiries. We anticipated specific questions focused on Cleveland Clinic and our physicians, but instead the information on the site was hard to decipher, confusing to reporters, and the surprises came from other organizations, not the government. More effort was spent correcting the information or clarifying the context of the dollar amounts posted. The stories seemed to focus more on the website and data rather than the hospitals and individuals.
Some of the challenges included clarifying "charges" for items companies listed that our physicians didn’t see coming. For example, a $50 charge for a lunch a doctor did not attend. Or, in another case, a "donation" of a drug for a study conducted by another physician. One doctor told me he was asked to contribute to an article by a publishing company. Weeks later he received a check from a pharmaceutical company that he later donated, but had no idea it was posted as income to him from the company.
From a communication perspective, as this recent episode clearly underscores, it’s important to plan as much as possible, but also to act quickly and adjust based on the changing circumstances. Be flexible. Have a team that can work together and deal with the uncertainty of the situation. As the story evolves, so will responses, messages, and strategy. In the end, of course, the ultimate objective of all communications activity is that the patients benefit.
Eileen Sheil is executive director of corporate communications at Cleveland Clinic, one of the country's top nonprofit academic medical centers. Her column will focus on the myriad challenges of healthcare PR and topics related to the management of the comms function. Sheil can be reached at sheile@ccf.org.
