The system will be the product of a patient safety task force, made up of four federal agencies: the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, the Food and Drug Administration and the Health Care Financing Administration.
Health and Human Services Secretary Tommy Thompson, speaking at a gathering of those agencies and medical professionals Monday, said the task force would work with state and private organizations to design the system.
"We will streamline the reporting burdens that providers face today, and we will make important findings more accessible, more quickly to the providers that need to know," Thompson said in prepared remarks.
Hospitals and other health care providers already report much of the data the task force is looking for, said Dr. John Eisenberg, AHRQ's director.
"If there's an adverse reaction to a drug, doctors are supposed to fill out a form and send it to the FDA," Eisenberg told United Press International. "If a patient acquires an infection in a hospital, that information is supposed to be sent to the CDC. We don't want to change the nature of that data, we just want to change our success in getting it."
The database's stated purpose is to help create better training and operational practices to prevent medical mistakes, such as operating on a healthy limb or organ. Eisenberg said medical personnel reporting errors would remove all patient data before the entry went through the system. Practitioner-specific information would also be erased, he said.
"There's a difference between gathering information for learning and collecting it for external accountability," he said. "The purpose here is to collect it for learning. There's been substantial research that shows when people are in fear of reprisal, they tend not to collect the data and it's incomplete."
Collecting information in a patient- and doctor-neutral manner is the only way to go now, but more needs to be done, said Kevin Piper, director of National Health Care Purchasing Institute.
"It's a positive first step to gather the information now," Piper told United Press International. "In the long run, [anonymity] is an untenable policy to have. Once you build the credibility of the underlying information, it's a necessity to release it because lives are at stake."
Piper said the proposed reporting system will improve care.
"You'll get slow but measurable improvements early on," he said. "Anytime people have to sit down and write down, 'I screwed up, and this is what happened,' even when it's confidential, that involves a thought process and introspection. That will have positive fallout."
Eisenberg envisions the HHS system as a series of simple drop-down menus, with a nationwide standardized vocabulary. Medical staff would select the proper entry for each item. The collected information would be sent over the Internet to the central database, he said, where it would generate learning materials to guard against future mistakes. The database's large sample size will help provide a better national baseline for doctors to compare their performance against, Eisenberg said.
As for the cost of implementing such a system, Eisenberg said the Bush administration had requested between $10 million and $12 million for the infrastructure. Individual hospitals shouldn't need to buy additional computer hardware to take part, he said. The system's possible benefits could prompt those lagging behind technologically to catch up.
"There might be bigger savings than there will be costs," Eisenberg said. "We've found that by eliminating medication errors, hospitals can save as much as $500,000 annually in direct costs."
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