Commentary: Congress needs to join employers and other health care stakeholders in efforts to accelerate the pace of improving patient safety. The Patient Safety Movement also is seeking congressional support, advocating legislation that promotes better health information technology, especially interoperability, thereby reducing medical errors.
Advocates note HIT systems need to be interoperable, so that units within hospitals can communicate quickly and accurately, as well as be able to share data with other hospitals. Evidence shows that where such systems are functioning correctly, medical errors especially related to medications are substantially lower.
Also see: Disney's tale of health IT
The Politics of Patient Harm: Medical Error and the Safest Congressional Districts, a report prepared by Michael Millenson of Health Quality Advisors and John Morrow of iVantage Health Analytics, attempts to gain the attention of lawmakers on this issue by rating congressional districts by patient safety. In the process, the authors identify the 10 safest congressional districts and the 10 most unsafe. It notes that the 10 safest Congressional districts were almost two times safer than the 10 least safe.
The co-authors recommend some specific actions that Congress can take:
- Demand expanded safety data collection and reporting in easily comprehensible formats for both the inpatient and outpatient environment.
- Provide the mandate (and the funding) to ensure that safety information is collected and disseminated rapidly. The way in which safety information is currently collected from billing data is inconsistent and less reliable than the life-and-death stakes demand.
- Create clear standards for publicly reported performance measures.
- Encourage all hospitals in their districts to be publicly open about the safety of their care and to cooperate with other institutions to improve it.
- Support research. There are Congressional caucuses devoted to helping cure a number of diseases, yet despite the appalling human and financial cost of medical error, there is no patient safety caucus.
- Increase funding to the Agency for Healthcare Research and Quality and other relevant agencies that build the vital evidence base for safety improvement.
- Demand accountability for eliminating harm.
- Mandate that all hospitals attain as rapidly as possible the reductions in patient harm that other hospitals have already demonstrated are possible.
The time for talk is over. It's been 15 years since the Institute of Medicine called the nation's attention to the extent and cost of medical errors and, with few notable exceptions, the problem has gotten worse, not better. Real health care reform won't be achieved unless quality, affordable care is first and foremost safe care, says Millenson.
Also seeking the clout of Congress is the Patient Safety Movement, which earlier this month held a briefing for Capitol Hill staffers soliciting support for legislation promoting systems of interoperable systems of HIT.
At least three bills have been or soon will be introduced that contain sections designed to encourage interoperability. Also, the Sustainable Rate of Growth Repeal of the Medicare Physician Fee Schedule includes a provision stipulating that providers must demonstrate that they have not attempted to compromise the compatibility or interoperability of electronic health records.
According to PSM president Jim Bialick: Health information is an invaluable tool in detecting preventable patient deterioration or in medical errors before they happen. The promise of HIT, however, will never be realized unless disparate systems are able to communicate and until patients and providers are able to rely on the accuracy, security, and completeness of those communications. Unfortunately, after spending $30 billion taxpayer dollars on EHRs, we are not there yet, and we are going to need Congress set deadlines for interoperability.
The PSM also recently released two more of its Actionable Patient Safety Solutions, one dealing with sepsis and the other with resuscitation. The PSM credits the adoption by hospitals of its first nine APSSs for preventing about 6,400 deaths last year. PSM has a goal of zero preventable deaths by the year 2020.
Ozga is president of Medical Business Exchange.
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