CMS recently released Open Payments records, detailing which doctors and institutions were paid by which manufacturers. You will be able to see the financial relationships that physicians and hospitals have with healthcare manufacturers.
The problem? In Open Payment records, CMS did not include the National Provider Identification (NPI) numbers that correspond to the providers. NPI numbers are identifiers that uniquely identify healthcare providers and organizations, and are used by industry. This omission is unfortunate because other healthcare data sets — such as the National Plan & Provider Enumeration System’s dataset , Physician Referral Patterns, and the Medicare Provider Utilization and Payment Data — all use the NPI to identify doctors.
Consequently, the Open Payments data is isolated from other data sets, making interesting relationships more difficult to discover.
DocSpot will apply its matching process to determine the NPI numbers from the information specified in the Open Payments records for individual physicians. DocSpot has honed this matching process over five years, having worked with data from millions of different documents. While we don’t expect a 100% match rate (e.g. not all practicing US doctors have a NPI number, some doctors have moved), we are optimistic about the results.
This data can be used by consumer websites and non-profits to give consumers increased transparency and better information in choosing a healthcare provider.
By linking the disparate data sets, enterprising journalists and researchers can uncover meaningful and hidden relationships within the healthcare ecosystem. A classic study would be to pair Open Payments data with Propublica’s Prescriber Checkup data and see if there is any correlation between payments and prescriptions.
The project might also be useful to pharmaceutical companies and healthcare manufacturers interested in competitive analysis and may even help identify which providers are considered industry thought leaders by other companies.
With NPIs from this project, payers can link the Open Payments data with their own claims databases and see if they find any correlations between payments and prescription patterns.
The end product is a list of NPI numbers that correspond to the records of Open Payments, which will be available to the backers of this project (see rewards for the terms) via a password-protected secure download URL. Our experience is that a matching project like this will require multiple runs to process and refine and proceeds will help pay for the salaries of those working on this project. Additionally, we may also hire contractors to help verify and manually match more difficult cases. After CMS updates the database in 2015, we plan on running the matching algorithm again and posting the updated results for the backers.
The time and effort to do this will eventually be done; it’s just a matter of who does it and how many times it gets done. Rather than many different organizations expending the time and effort to do a mediocre job, the proposal is to pool resources to have one organization do an excellent job.
Jerry Lin, founder of DocSpot, has been working on helping people find doctors for over five years. Jerry believes that patients need more information to make more informed decisions when selecting doctors and is excited that more and more physician-level data is coming online. Jerry studied computer engineering at Stanford and has worked in a number of roles at the intersection of health care and technology.
Jared Cordova is a product developer and joined DocSpot over four years ago. He studied Symbolic Systems at Stanford, blending computer science with cognitive science. Jared has a longstanding interest in bringing relevant health information to consumers: several of his family members are either in the medical profession or have struggled with chronic health conditions.
T-shirt acknowledging support of provider transparency.
Academic researchers can get a copy of the database for their research. Any published research must cite DocSpot's work. Large-scale display of individual records not permitted under this reward. One t-shirt included.
Media organizations can get a copy of the database for their journalistic purposes. Any published articles based on this database must cite DocSpot's work. Large-scale display of individual records not permitted under this reward. Five t-shirts included.
Publicly available websites can get a copy of the database if it agrees to show the Open Payments records without requiring any login, subscription, or payment from consumers. Website must offer a search-engine-friendly link back to DocSpot, citing its involvement in the project, and must cite DocSpot's work in any published articles or research. Five t-shirts included.
Organizations can get a copy of the database for public and private use. Database cannot be re-sold unless part of a larger sale that involves significant private data. No link or citation back to DocSpot required (but certainly appreciated). Ten t-shirts included.
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