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Federal
Agencies To Adopt Uniform Health Information Standards
Senators
Call For Panel To Monitor Health Care Safety Net Trauma
Care Has Improved; But Services Lag In Rural Areas
New
CME Program To Promote Quality Improvement
Federal
Agencies To Adopt Uniform Health Information Standards The Departments
of HHS, Defense, and Veterans Affairs have announced plans to develop uniform
standards for the electronic exchange of clinical health information within the
federal government. HHS said the
three departments are coordinating with other federal agencies to standardize
federal clinical health information as part of President Bush’s Consolidated Health
Informatics initiative, known within the federal government as the CHI initiative.
Under the plan,
all three federal agencies will adopt Health Level 7 (HL7) messaging standards,
National Council for Prescription Drug Programs (NCPDP) standards, the Institute
of Electrical and Electronics Engineers 1073 (IEEE 1073) series of standards,
Digital Imaging Communications in Medicine (DICOM) standards, and laboratory Logical
Observation Identifier Name Codes (LOINC). Additional standards are still in development
by representatives of the three cabinet agencies under the CHI initiative. Officials said
the new standards will help improve the quality of care by ensuring federal entities
use a common coding system that will make it easier to coordinate care and exchange
needed information. Medicare officials
are discussing ways to promote adoption of electronic health record technology
by physicians and providers once the three departments have adopted the full set
of CHI standards. For more info,
www.hhs.gov. Senators
Call For Panel To Monitor Health Care Safety Net A group of
senators unveiled plans to introduce a bill that would provide for the creation
of an independent commission to monitor the system of providers caring for underserved
populations. The commission
would be modeled on the Medicare Payment Advisory Commission, and would be called
the Safety Net Organizations and Patient Advisory Commission (SNOPAC). Members
of the group include Senate Finance ranking member Max Baucus (D-MT), Judiciary
Committee Chairman Orrin G. Hatch (R-UT), James M. Jeffords (I-VT), and John D.
Rockefeller IV (D-WV.). The group said
SNOPAC would track changes in the status of the health care safety net; link and
integrate existing data systems related to the safety net; and establish an early-warning
system to identify impending failures of health care safety net systems and providers.
The new commission would make recommendations to Congress as to how to best preserve
and improve the health care safety net, the senators said. The proposal
is for 13 commissioners to serve on SNOPAC, generally serving three-year terms.
Commissioners would have expertise in the financing and delivery of health care
services, economics and reimbursement, the senators said. The commission also
would include health professionals, employers, and recipients of care from the
safety net. Baucus pointed
out that no entity currently supervises safety net providers—including public
and teaching hospitals, emergency departments, community health centers and rural
health clinics. He noted that a recent report by the General Accounting Office
found that hospital emergency departments are facing severe overcrowding problems,
and are forced to send patients to other hospitals. For more info,
www.senate.gov/~baucus. Web-Based
System To Track Medical Errors In California A new Internet-based
system will track medical errors at five University of California medical centers.
The University of California project is believed to be the first in the nation
that links academic medical centers on a system-wide basis through the Internet.
The system
will allow hospitals to monitor trends in medication errors such as administering
the wrong drug or the wrong dosage. It also will establish a "harm score
system" for evaluating each error and comparing it with others. Various health
care providers have used the systems to improve quality and efficiency. In February,
Kaiser Permanente, the state’s largest HMO, rolled out a $1.8 billion plan to
give doctors and patients access to medical histories, test results, prescription
information and other data, in part to reduce errors. The system
will not be accessible to patients. However, patients may make suggestions and
notify medical authorities if they experience or witness medical errors or near
misses, said Dr. Lee Hilborne, director of the UCLA Center for Patient Safety
and Quality. For more info,
http://quality.mednet.ucla.edu. Trauma
Care Has Improved; But Services Lag In Rural Areas The country’s
trauma centers have made improvements in how serious injuries and mass casualties
are treated, though rural care continues to lag. The report,
published in the March 26 Journal of the American Medical Association,
found that the number of U.S. trauma centers has more than doubled since 1991,
from 471 to 1,154. But 15 states continue to lack a system for certifying the
centers, and more than 90% of the best-equipped Level I and Level II centers are
in metropolitan areas. The report
said that rural areas lag in comprehensive trauma care because many don’t have
the necessary equipment and personnel. The researchers suggested that trauma victims
in such areas be given initial care, then transferred "outside the immediate
region" for specialized aid. The authors
added that regularly creating an inventory of trauma centers could help officials
coordinate sites to handle disasters and terrorist attacks. For more info,
www.jama.ama-assn.org. New
CME Program To Promote Quality Improvement The Centers
for Medicare and Medicaid Services has unveiled a new Continuing Medical Education
(CME) program that will award credit to physicians participating in outpatient
health care quality improvement projects with Quality Improvement Organizations
(QIOs)—a network of private organizations that contract with Medicare to improve
care for seniors. "This
initiative is an important step to help ensure the quality of health care for
millions of Americans," CMS Administrator Tom Scully said. "The program
provides an opportunity for physicians to build their quality improvement capacity
while earning CME credit for their efforts to improve care." As part of
this CMS national pilot program, the American Medical Association will award AMA
Physician’s Recognition Award (PRA) category 1 credits to physicians who participate
in projects designed to improve the care provided in their offices and/or outpatient
clinics. The program also is part of an American Academy of Family Physicians
pilot to award CME credit to family physicians. Physicians
can earn up to 10 CME credits per year in each of three clinical areas including
diabetes, influenza/pneumococcal immunizations, and breast cancer screening. Additional
clinical areas may be added in the future. CMS will cover
costs for 30 CME credits per year for the first 100 physicians within each state.
Most QIOs will cover the costs for all additional participants in their states,
CMS said. Physicians
can enroll in the program through their local QIO. Participation requires a change
in their office practice designed to improve clinical performance on specified
quality indicators, such as the use of clinical flow sheets for patients with
diabetes in order to improve appropriate test rates of hemoglobin A1c, serum lipids,
and eye exams. An ongoing
measurement process will assess performance and evaluate the impact of office
practice changes on quality of care. The Iowa Foundation
for Medical Care will coordinate national implementation of the program. IFMC
developed the new CME program in collaboration with the University of Iowa College
of Medicine, MassPRO, the TMF Health Quality Institute, and the Virginia Health Quality
Center. All QIOs are
participating in the national CME program except Alabama, Puerto Rico, and the
Virgin Islands. In these QIOs, physicians can earn CME credits through traditional
medical education programs rather than through their involvement in quality improvement
projects. For more info,
www.cms.gov. Publications Using
a Market Model To Track Advances in Patient Safety, Journal on Quality and
Safety, March 2003. Article addresses how reducing medical errors has become
a new market driver in health care, and proposes a model to understand the provider
community’s response to these market conditions as patient safety initiatives
mature. For more info, www.jcrinc.com. Understanding
and Responding to Adverse Events, The New England Journal of Medicine, March
13. Article addresses how to investigate clinical incidents and learn useful
lessons from them, and how to support patients, families, and staff members involved
in adverse events. For more info, www.nejm.org. HIPAA
101: The Basics of Administrative Simplification, The Centers for Medicare
and Medicaid Services, April 16. CMS will present a free satellite
broadcast to inform health care providers about the administrative simplification
provisions of the Health Insurance Portability and Accountability Act (HIPAA).
For more info, www.cms. Translating
Research Into Practice: What's Working? What's Missing? What's Next?, Agency
for Healthcare Research and Quality, July 22-24, Washington, DC. The first
in a new annual series, this conference will examine successes and challenges
in implementing research findings faced by patients, communities, physicians,
practices, health care organizations, national and local governments, payers,
educators, and the media. For more info, www.bls Disease
Management Leadership Forum, Disease Management Association of America, Oct.
12-15, Chicago, IL. The forum is an opportunity to learn about model programs
and the innovative methods for addressing the hot issues in disease management,
as well as network with over 1,000 decision makers from all segments of the industry.
For more info, www.dmaa.org.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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