Systems corrections may help reduce medical errors

By William Langbein

SAN FRANCISCO (Reuters Health) – An unlikely coalition between major corporations and large national unions may offer hope to correct the problem of medical errors that has captured the public's attention for the past two years, according to a panel of consultants speaking at the JP Morgan H&Q conference here.

The panel titled, "Medical Errors: The Problem and the IT Response by Employers and Government," said that more scrutiny by payers, the implementation of HIPAA technology standards and more investment in information technology would aid in reducing medical errors.

Corporations and unions are both payers of health insurance and own obligations to provide long-term healthcare benefits to their respective constituencies. After a lull in the mid-1990s, both are again faced with rising healthcare costs. As they negotiate contracts with health plans, they are discovering they own less leverage because fewer insurers are willing to take on the risk, in spite of the benefit of the large contract.

To attack rising costs, both groups are beginning to challenge how well providers are using their capital budgets, according to Dr. Arnold Milstein, director of the standards committee of the Leapfrog Group. The Leapfrog Group is a coalition of healthcare purchasers committed to common purchasing principles that can drive "leaps" in patient safety.

In examining the capital budgets, purchasers are urging providers to invest in information technologies and systems that can reduce medical errors and enable all providers — hospitals, medical research centers and small physician groups — to operate more efficiently.

Instead of directing capital for new parking lots or support for adjacent medical office buildings, for example, purchasers are encouraging providers to direct more investment in technology, said Milstein.

Investing in information technology was a central recommendation of the Institute of Medicine's 1999 report, "To Err is Human," noted Dr. Molly Joel Coye, president and CEO of the non-profit Health Technology Center. The investment is even more vital now as providers prepare for a future that will include advances in drugs and medical devices. Current provider information technology systems are unprepared to accept the technologies of the future, said Coye.

Milstein said that the Leapfrog Group's strategy involves creating universal scorecards to measure the comparative value each provider delivers and to tangibly reward good performance. The scorecards would help advance consumerism when choosing health plans and providers, thereby applying the same market principles its members use when deciding on other purchases.

Corporations within the Leapfrog group also intend to improve their alliances with labor unions and to make an effort to redirect the media's attention on HMOs. An HMO's quest for profits has had little influence in provider efficiency or patient safety as commonly reported by the media, said Milstein. The more significant problem in patient safety lies in the failure to re-engineer operations at the small provider and hospital level.

The panel predicted that information technology improvements would be implemented by the existing legacy providers of technology to hospitals such as Cerner Corp. and McKesson HBOC. They also said that the dot-com failures of the past two years would not deter providers from making the necessary system improvements to upgrade patient safety.

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