Utah's not keeping everything under wraps. Under a presidential directive, the new buzzword for health care is "transparency." What's meaningful, though, is a contentious topic.

Transparency is supposed to mean giving everyone, from patients to doctors and nurses and administrators, enough information to make good choices.

Transparency is important, says Dr. Brent James. an Intermountain Healthcare vice president with a national reputation as a patient safety expert, for making the decisions that go into care, such as which of two procedures to choose for a certain patient. It's using evidence-based medicine — what is known from actual research, not anecdote — to determine the course of care.

As a result of that directive, the Utah Legislature ordered the state health department to produce reports showing what certain procedures cost and offering information on quality, all available online. It's part of the transparency move. But those numbers, too, get criticized as superficial. John Doe can see average costs for a procedure but not what his insurance company actually pays, since they negotiate discounts.

And the number doesn't mean much unless you know whether the average charge at a facility is higher because it treats a lot of ill, elderly patients, who are more complicated and costly to care for than a young, athletic individual. So comparing hip replacement costs or complications may be misleading. It doesn't tell the fictional Doe, who is healthy except for that hip he broke in a biking race, what he will be asked to pay or really what his care will be like.

And, in the end, he'll still probably decide where to be treated based solely on his insurance and his doctor's privileges.

Real transparency, some experts say, would also include information on what kind of complications patients experience, plus system failures and what hospitals and surgery centers are doing to fix them, and a lot more.

---

E-mail: lois@desnews.com