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In May, I exulted that some 90 percent of hospitals had signed up voluntarily to share safety data. This month, I can cheer that some 95 percent of eligible hospitals have done so. By 2005, the Centers for Medicare and Medicaid Services, or CMS, plan to launch a Web site for consumers, and some of the data is already available. The information will help patients pick the best hospitals and help hospital administrators design safer procedures.
Indeed, while sexier technologies for catching mistakes generally grab the headlines, an equally valid use of software is to analyze workflow systems to identify safety risks. But that kind of analysis cant happen (or at least cant happen as effectively) without the kind of data that should eventually come out of this project.
The 10 clinical measures to be monitored involve such straightforward, yes-no questions about patients diagnosed with heart failure, heart attack or pneumonia as, Was a heart patient offered aspirin? Did a pneumonia patient get an antibiotic in a reasonable amount of time? According to CMS, which plans to expand the number of measures, the “starter set” has had years of clinical validation and testing by CMS and the Joint Commission on Accreditation of Healthcare Organizations; they were proposed by the National Quality Forum by CMS request.
Still, whats most encouraging is the power of the nations largest health care payer to influence health care providers. While CMS has made reporting voluntary, hospitals failing to report a set of 10 measures in three disease areas wont receive a 3.3 percent update in inpatient prospective payment systems approved for next year. Thats a small percentage that contributes a whole lot of motivation for hospitals to shape their systems.
But CMS is relying on more than money. It is working closely with a long list of relevant groups including the American Hospital Association, the Federation of American Hospitals and the Association of American Medical Colleges. In fact, I learned of the 95 percent success rate when the AHA reported it from communications with CMS.
There are still hurdles: Hospitals that focus on rehabilitation, children and psychiatric care are generally not included. Not all acute hospitals are signed up. And, according to the AHA, CMS had questions about the quality of the data submitted by a few of the hospitals.
Government groups also hope to wield such influence over processes like e-prescribing and electronic medical records. While these initiatives are, admittedly, more complicated, CMS and other government agencies are firmly committed to bringing such technologies to patients. And, so far, the Hospital Quality Initiative has displayed the kind of savvy necessary to do so.