Quality Update for February 5, 2004

Senate Testimony Supports Quality Initiatives Study: Health Care Spending Yields Improvements Hospital Quality Ratings Major Factor Among Consumers New Computerized System Designed in Texas to Improve Patient Safety Oregon Forms Patient Safety Commission Analysts Predict Small Practices to Invest in EMRs EMRs Gain Political Momentum Senate Testimony Supports Quality Initiatives Improving health care quality through information technology and publicly reporting quality data will ultimately reduce rising health care costs, several panelists told a Senate health committee recently. The Senate Health, Education, Labor and Pensions Committee held a full committee hearing Jan. 28 to address rising health care costs and the uninsured, inviting testimony from policy leaders, federal officials and non-profit organizations. “Rapidly rising health care costs and the significant number of Americans without health insurance are serious problems that have grave economic and social implications for the U.S., both domestically and globally,” said Sen. Judd Greg (R-N.H), who chairs the HELP Committee. “Addressing these problems is perhaps one of the most important domestic challenges facing our nation and a top priority for the HELP Committee.” Three of the five witnesses cited quality initiatives such as public reporting, patient safety, reducing medical errors and adopting an information technology infrastructure as possible ways to curb rising costs. Karen Davis, president of the Commonwealth Fund called for a long-term goal of fundamental reforms and also suggested short term steps, including health IT systems and the public reporting of quality data. Gail R. Wilensky, senior fellow at Project HOPE, said the current reimbursement system was one of several drivers in spiraling health care costs, along with advances in medical technology, medical errors and patient safety, medical liability and lifestyle issues. Dr. Arnold Milstein, medical director, Pacific Business Group on Health, focused his comments on what he characterized as “large inefficiencies” in the American health care delivery system, noting that waste accounts for more than 40% of health care spending in this country. He argued that innovators in American health care have generated savings far in excess to their costs. To encourage the mainstream health system to adopt the same programs and savings, he recommended publicly releasing longitudinal efficiency and quality ratings of doctors and hospitals, and making such reports routine. Other speakers included Douglas Holtz-Eakin, director of the Congressional Budget Office and Christopher Conover, director of the Health Policy Certificate Program and a senior research fellow with the Health Inequalities Program Center for Health Policy, Law and Management at the Terry Sanford Institute of Public Policy. For more info, http://health.senate.gov/bills/035_bill.html. Back to top Study: Health Care Spending Yields Improvements Health care spending in America over the least two decades has resulted in a healthier, more productive population and improved quality of life, according to a study released Jan. 28. The study, conducted in part by the American Hospital Association, found that spending increased $2,254 per capita between 1980 and 2000, the overall death rate fell 16% and life expectancy increased 3.2. Disability rates also dropped 25% for people 65 and older and American spent 56% fewer days in the hospital. Researchers also reported major improvements in outcomes for heart attack, stroke, diabetes and breast cancer since1980. The study concluded that every dollar spent on health care yields a return of $2.40 to $3 due to health gains. For more info, www.hospitalconnect.com/aha/value/index.html. Back to top Hospital Quality Ratings Major Factor Among Consumers A study released Jan. 26 by HealthGrades indicates that 40% of consumers consider a hospital's quality ratings in choosing a hospital. The survey was conducted through random dialing of 4,070 households between Jan. 8 and 19. Respondents were first asked whether they, or a member of their family, were hospitalized within the past year and did not arrive at the hospital via ambulance. Respondents answering yes (958) were asked whether the hospital's quality ratings were considered when making their hospital choice. Hospital quality ratings were defined as awards, honors or recognition for top quality given by governmental institutions, private companies, or media organizations. The margin of error is +/-3% at a 95 percent confidence level. More detail is available from HealthGrades. “This is very important because there is an enormous gap in the quality of care from hospital to hospital. Forty percent, however, is not enough. With more consumer-friendly information regarding hospital quality on the Internet and elsewhere, it is critical that more consumers take advantage of this information,” said Samantha Collier, MD, HealthGrades' vice president of medical affairs. For more info, www.healthgrades.com Back to top New Computerized System Designed in Texas to Improve Patient Safety Huguley Memorial Medical Center in Fort Worth, TX, has been using a new computerized patient management system since last month to improve patient safety and security, reduce medical risks and streamline communication reports. The system allows physicians to access a patient’s lab results, X-ray reports and vital signs from outside the hospital. It is designed to alert clinicians about possible drug interactions, allergies and side effects. Physicians can also view notes on a patient from consultingdoctors. Huguley also plans to roll out a medication bar coding system and hopes to install a computerized physician order entry system this year or in early 2005. For more info, www.huguley.org. Back to top Oregon Forms Patient Safety Commission The Oregon state legislature has formed the Patient Safety Commission, a semi-independent agency with a mission to improve patient safety by reducing the risk of serious adverse events occurring in Oregon’s health care system and by encouraging a culture of patient safety in Oregon.” Hospitals and other health centers can choose to participate. If they do, they must report all medical errors to the panel and notify affected patients in writing. Participants in Oregon's plan include hospitals, long-term care homes, pharmacies and nonhospital surgery and birthing centers. The commission's 17 members include the state health officer, Dr. Grant Higginson, and 16 others appointed by Gov. Ted Kulongoski. Case reports will be confidential, but the commission will publish yearly summaries of the data, suggesting trends, patterns and lessons learned. Participants that fail to report and deal with serious errors will be expelled from the program and listed on the Web site as noncompliant. Back to top Analysts Predict Small Practices to Invest in EMRs A report from Forrester Research predicts that physician sales in electronic medical records will skyrocket from $816 million in 2003 to about $1.4 billion in 2008, with much of the spending coming from physician offices with eight doctors or fewer. In that five-year span, analysts predict that small physician practice spending on EMRs will more than double from $366 million to $829 million. Forrester analyst Eric Brown said patient safety was one of the reasons as well as pay-for-performance initiatives and growing sentiment among physicians that information technology can improve productivity and efficiency. For more info, www.forrester.com. EMRs Gain Political Momentum Electronic medical records are gaining political attention that could help fuel their adoption, American Medical News reports. In its Feb. 9 edition, American Medical News reported that while momentum is building for federal legislation to promote universal adoption of electronic medical records, many physicians remain concerned that they might get steamrolled in the process. The Bush administration last year commissioned the Institute of Medicine to design a standardized model of an electronic medical record, which the Department of Health and Human Services expects to have a model record ready this year. Last month, two key Democratic senators, both of whom serve on the Health Committee, announced legislation that could help speed adoption. Sen. Hillary Clinton of New York outlined a bill that would mandate the development of standards for electronic records and provide funding for physician offices to buy the systems. Sen. Edward Kennedy of Massachusetts also announced that he would introduce legislation including an electronic records provision. Physician groups have supported the concept of moving toward electronic records with data exchange capabilities but want to avoid an unfunded mandate. For more info, www.amednews.com Back to top

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