Reading-"Patient Safety Bill"

Patient Safety Bill A Concern

Critics say hospitals could hide data related to errors, infection

By Roni Rabin

September 30, 2003

Consumer advocates warn that a bill overwhelmingly passed by the House of Representatives could be used by hospitals and doctors to prevent disclosure of information now available to help patients make smart health care choices.

The bill, titled Patient Safety and Quality Improvement Act, could undermine recent initiatives like the development of hospital report cards, the advocates say.

But sponsors and supporters of the bill, which sailed through the House last March with the broad bipartisan support of 418 members, say it is intended to foster a non-punitive environment that encourages practitioners to report errors so they can learn from past mistakes. They say it will not prevent the release of any information that is now publicly available.

The bill has yet to face a vote in the Senate.

Consumer advocates cite the ambiguous wording of the bill, which makes all "patient safety data," defined as information collected or developed by a health care provider "for reporting to a patient safety organization," confidential.

Consumers Union, the nonprofit publisher of Consumer Reports, is concerned the broad definition of "patient safety data" could be used to include data collected for safety purposes, such as hospital infection rates, medical errors or adverse outcomes, according to a statement released by Consumers Union.

"The Patient Safety and Quality Improvement Act could - and we have to be precise, could - pre-empt state hospital quality and patient safety laws," said Bruce Boissonnault, who last year presided over development of one of the first report cards that graded and compared the quality of care in all hospitals in New York State.

The report card relied on a large state database of information on discharges from hospitals. The data is submitted to the state and can be publicly obtained under the Freedom of Information Act.

Boissonnault, executive director of the Niagara Health Quality Coalition, a nonprofit group of businesses, health plans and consumer groups, said he is concerned that health care providers could use the broad language to label everything "patient safety data."

"Once something is called 'patient safety data'... it becomes confidential data that is not discoverable, and drops off the face of the earth," he said.

Of the argument that hospitals need to provide a non-punitive atmosphere for reporting errors, he said, "Hospitals have had a safe environment for reporting medical errors for a hundred years."

A spokesman for Rep. Carolyn McCarthy said the congresswoman found value in the proposal.

"The intent is to curb health care errors by creating an environment of sharing information ... instead of fostering an atmosphere of blame," Scott Rowson said. "Representative McCarthy was a nurse for 20 years, and she recognizes the need to balance the public's right to know and the needs of hospitals.

"Her point would be, 'Let's stay diligent and make sure this is not abused or used to cover up anything.' And 417 other members agreed with her."

The bill cites the 1999 Institute of Medicine report, "To Err is Human," which estimated that as many as 98,000 Americans die each year as a result of medical errors.

It adds that "Many organizations currently collecting patient safety data have expressed a need for legal protections that will allow them to review protected information."

The bill was supported by several hospital trade associations, including the American Hospital Association and the Greater New York Hospital Association, as well as the American Medical Association.

Nancy Foster, senior associate director for policy of the American Hospital Association, said the intent of the bill is not to weaken any current state requirements.

"We don't have the precise language that would allow us to describe it ... but the intent, I believe, from all our conversations with the authors, has been to preserve access to information that is currently available to patients and the public," she said.

But Arthur Levin, director of the Manhattan-based Center for Medical Consumers, a nonprofit advocacy group, said disclosure of hospital performance and comparative rankings drive improvement.

"Sunshine is a very important piece of this," he said. "Advocacy organizations are worried this will turn back the clock on the meager progress we've made."

Responding to questions yesterday, Sen. Charles Schumer (D-N.Y.) said he has some concerns about the bill.

"Our concern is that the reporting language in this bill pre-empts New York State law, which is good in this area," he said, "and we're trying to work that out."

Copyright (c) 2003, Newsday, Inc.


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