A national system designed to increase reporting of medical errors has won final congressional approval and been sent to President Bush.
It is estimated that more than 250 Americans die every day as a result of preventable medical errors. Health care officials say increased reporting of such errors would make it easier to spot harmful trends and find solutions, but the current environment punishes openness because reporting such errors could lead to the loss of credentials or a lawsuit.
Under the legislation approved overwhelmingly by the House, health care officials would voluntarily report medical errors to patient safety organizations, which would use a network of computer databases to analyze the information and make recommendations on ways to improve health care. The information would be treated as privileged and confidential.
The administration called the legislation “a critical step toward the president’s goal of high-quality, patient-centered health care.”
The Congressional Budget Office estimates that the operation of the data collection system will cost about $58 million over the next five years.
“I believe this bill will be the first assault on the culture of fear that has permeated medicine for many years now,” said Rep. Michael Burgess, R-Texas.
Similar legislation passed both chambers of Congress last year, but the session ended before a final agreement could be reached. This time, the House and Senate bills are identical, so the bill only needs the signature of President Bush before becoming law. The Senate approved the measure last week.
The bill had the support of Republicans and Democrats.
“Medical errors take lives, medical errors waste money and medical errors are largely preventable,” said Rep. Sherrod Brown, D-Ohio. “We know medical errors are underreported. That’s disturbing but hardly surprising. This legislation is designed to overcome that obstacle.”
The House vote was 428-3. The only lawmakers to vote against the bill were Republican Reps. Jeff Flake of Arizona, Ron Paul of Texas and Virginia Foxx of North Carolina. Not voting were Democrat Robert Brady and Republican Timothy Murphy, both of Pennsylvania.
The American Medical Association and the American Hospital Association supported the legislation, as did the Amercian Association for Retired Persons.
Dr. J. Edward Hill, president of the AMA, said the legislation would not harm consumers’ rights to access the legal system if they are harmed by medical error. “I think employees and physicians will be excited about the ability to make positive suggestions about how to improve systems so errors won’t occur,” said Hill, a family physician from Tupelo, Miss. “This way, we learn from our mistakes.”
The Bush administration said the legislation would reduce the number of lawsuits resulting from medical error.
“Information from medical records and existing data sources will continue to be made available for injured plaintiffs to pursue their claims in court, just as that information is available today,” said a statement released by the Office of Management and Budget.
In 1999, the Institute of Medicine, which advises the federal government on science and technology, reported that up to 98,000 deaths occur every year in U.S. hospitals as a result of medical errors. The number is often cited by lawmakers when they describe why the national database is needed.
“This makes medical errors the eighth leading cause of deaths each year — more than car accidents, breast cancer or HIV/AIDS,” Senate Majority Leader Bill Frist, R-Tenn., said prior to the House vote.
However, some health care analysts say the incidence of medical errors leading to death has been exaggerated.
“The reliance on studies without controls to make headline claims about huge numbers of preventable deaths was one error that (the Institute of Medicine) did not catch,” said the authors of an article published in July 2000 in the Journal of the American Medical Association.
While some health care analysts believe the number of deaths due to medical error has been exaggerated, that sentiment does not mean they oppose the establishment of a national reporting system.
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