Government

Medical error reporting system still a year off

Several agencies must review the rules that will govern the patient safety organizations to which physicians will report.

By Dave Hansen — Posted Aug. 20, 2007

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A national voluntary system for reporting medical errors is at least a year away from reality, according to the Agency for Healthcare Research and Quality.

President Bush signed the Patient Safety and Quality Improvement Act in July 2005. The system should be up and running by the middle of 2008, said William Munier, MD, acting director of AHRQ's Center for Quality Improvement and Patient Safety.

The agency recently moved one step closer to launch by soliciting companies to scrub the data so that patients and physicians cannot be identified. AHRQ also solicited a separate organization to study the information doctors and others report.

AHRQ put out a request for proposals in May for the two entities. The application period ended on July 9. Dr. Munier declined to state how many applications the agency received but said he was pleased by the response.

The next step is proposing regulations to govern the operation of patient safety organizations, said Dr. Munier. These are the entities to which physicians and other health professionals will be able to confidentially report errors and close calls. The PSOs will look for trends and feed patient safety data back to the health care community.

It is taking a long time to get the system going because the rules that will govern the PSOs must first be reviewed by multiple federal agencies, such as the Food and Drug Administration and the Centers for Disease Control and Prevention, Dr. Munier said.

"A lot of hands have to see them," he explained. The regulations also must meet medical information privacy requirements laid out in the Health Insurance Portability and Accountability Act, he said.

But Leapfrog Group CEO Suzanne Delbanco held others responsible for the delay.

"Organized resistance comes from those that represent the provider," stated Delbanco, whose organization is a national coalition of large health care purchasers. "I think there are many forces at work that would prefer data about performance be kept under wraps, and they can be quite effective in arguing we don't have enough privacy protections or enough sophistication to do it. All of these types of arguments can be very effective in delaying initiatives."

The American Medical Association supports the Patient Safety and Quality Improvement Act. "The health care community has long been committed to improving patient safety, and significant progress has been made through new technology, research and education," said then-AMA President J. Edward Hill, MD, after Bush signed the measure. "But federal legislation is the crucial element needed to truly expand broad patient safety reforms nationwide."

Dr. Munier noted that the act bars insurance companies from serving as PSOs. The act also protects information that is submitted to PSOs from legal discovery.

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External links

Agency for Healthcare Research and Quality summary of the Patient Safety and Quality Improvement Act (link)

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