Database would ease doctors' paperwork on patient safety

The Bush administration wants to establish an online site to streamline collection of patient safety data and to improve quality of care.

By Damon Adams, amednews staff. May 14, 2001.

An Internet-based database proposed by the Bush administration could reduce work for physicians filing reports on patient safety and create a central site for information on medical errors, best practices and other safety-related issues.

U.S. Dept. of Health and Human Services Secretary Tommy Thompson announced in April the formation of a patient safety task force, which the administration hopes will improve existing reporting and data collection and boost patient safety.

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"We can make much better use of the information we already collect, and we can translate that information into quality gains for patients," Thompson said in a statement. "At the same time, we will streamline the reporting burdens ... and we will make important findings more accessible, more quickly to the [physicians] who need to know."

Federal agencies leading the task force include: Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, Food and Drug Administration and Health Care Financing Administration.

The FDA, CDC and HCFA currently operate reporting systems to monitor adverse events, compliance with drug and medical device regulations and the safety of patients in Medicare-funded institutions.

Integrating these systems into one Internet-based database would create a user-friendly system with many benefits, Thompson said.

"This new format will enhance the value of the reporting system that already exists within HHS by allowing for faster cross-matching and electronic analysis of data. We then will be able to respond more quickly to patient safety problems and learn to prevent medical errors in the first place," Thompson said in unveiling the task force at the National Summit on Patient Safety Data Collection and Use in Reston, Va.

The new system likely would cut down on the amount of forms doctors and hospitals fill out when reporting adverse events.

"It is about reducing burden," said Gregg Meyer, MD, director of AHRQ's Center for Quality Improvement and Patient Safety. "Do you spend the time to fill out all those forms, or do you take care of the two people out there in your waiting room?"

Trend spotting

The database also would enable federal agencies to spot trends.

"It will permit us to have estimates of the frequency of [adverse] events like drug interaction or postoperative infections. It's important to be able to see whether there are trends," said Stephen F. Jencks, MD, MPH, director of HCFA's Quality Improvement Group, Office of Clinical Standards and Quality.

Doctors and hospitals would tap into the system via the Internet to make reports or read the collected data. Practice guidelines and drug alerts also may be provided.

"Our emphasis is on creating a system that promotes improved care," said Julie Gerberding, MD, MPH, director of the CDC Division of Healthcare Quality Promotion. "It's not just a data collection system. This is meant to be a knowledge system that supports the user."

Organizers said the intent was not to start a national mandatory medical error reporting system. The database will be confidential, with patient and physician names left out. The public will not have access.

The American Medical Association said a patient safety reporting system must: guarantee patient and doctor confidentiality, encourage reporting in a uniform format and provide information in a scientifically valid design to physicians and other health care professionals.

The Institute for Safe Medication Practices also supports the integrated reporting system. "We don't need more reporting programs. We need to make sure people are using information from the existing programs," said Allen Vaida, executive director of the nonprofit institute based in Huntingdon Valley, Pa. "You could have 100 reporting programs out there, but if you don't use the information for anything, it's worthless."

Dr. Meyer said the task force would develop an action plan and get a cost analysis for the database, which it hopes will be operating in two years.

The budget proposal for fiscal year 2002 allocates $72 million to improve patient safety -- a $15 million increase over last year, Thompson said.

Once the database opens, it will improve patient care in a major way, Dr. Meyer said. "We're talking about taking advantage of the data we're already collecting. We need to make these systems work better for us."