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September 12, 2007...Today, Sen. Richard T. Moore delivered testimony before the Joint Committee on Public Health in support of legislation he filed that would, among other things, require hospitals to report their rates of medical errors and hospital acquired infections (HAIs). 

"Massachusetts must act if it wants to remain a state that can justifiable claim to lead the national discourse on health care reform," said Moore, who chairs the Joint Committee on Health Care Financing. "The federal government and an increasing number of states and local governments are taking steps to better monitor and reduce HAI and medical errors." 

The text of Senator Moore's testimony is below:

Testimony of Senator Richard T. Moore before the Joint Committee on 
Public Health in support of S. 1277, An Act Relative to the Health Care
Transparency and Consumer-Provider Partnerships

Chairwoman Fargo, Chairman Koutoujian, members of the Committee, I am here to testify in favor of Senate Bill 1277 and its House counter part, House Bill 2226, An Act to Promote Healthcare Transparency and Consumer-Provider Partnerships. These bills aim at improving health care quality and reducing its costs by, among other things, requiring hospitals to report their rates of medical errors and hospital acquired infections (HAIs) and by giving patients and their families other important tools to protect themselves against these devastating yet preventable adverse medical outcomes. 

THE COSTS

The human toll of Medical Errors and HAIs is undeniable. 

• Nationally, the Centers for Disease Control estimates that annually over 2 million patients develop an HAI or suffer from a preventable medical error during their hospital stay. Of these, over 100,000 die. 

Financially, HAI and medical errors not only cost government and private health insurers billions of dollars, but also impact hospitals and other health care providers’ bottom lines. 

• In Massachusetts, the Department of Public Health estimates that HAI cost the state as much as $400 million per year. 
• The Institute of Medicine estimates the national cost of medical errors and HAIs is more than $30 billion a year.

Though the payers of health care bills currently shoulder the majority of these costs, hospitals are not immune from them.

• A recent report found that of 1.69 million admissions from 77 hospitals, patients with a healthcare-acquired infection resulted in a loss to the hospital of $5,018 per infected patient and reduced overall net inpatient margins by $286 million. (“Dispelling the Myths: The True Cost of Healthcare-Associated Infections.” Association for Professionals in Infection Control and Epidemiology, Feb 2007)
• A December 2006 study in the American Journal of Medical Quality found that central line associated blood infections cost a Pennsylvania hospital over $26,000 per infection and a total loss from operations of $1,449,306 in the 54 cases studied.

THE TIME TO ACT IS NOW

With this growing body of medical and financial data surrounding medical errors and HAIs and Massachusetts commitment to offer affordable health insurance to all of its residents, we must act now. Reducing or eliminating preventable medical errors is possible and a key to controlling the cost and improving the quality of health care in Massachusetts. 

This bill would work toward this goal by giving consumers tools to protect against preventable adverse medical events. It asks health care facilities to: 

• Publicly report infection rates and report so called “never events” to the Department of Public Health;
• Requires hospitals to notify patients about medical errors; 
• Exempts a doctor’s apology from lawsuits; and 
• Requires hospitals to establish Rapid Response Teams which patients and families could activate when immediate medical attention is needed

Each of these provisions are simple, but proven steps to reduce the likelihood of adverse outcomes in health facilities. They make such adverse outcomes more transparent to the state, hospitals, and patients, and reduce the rate of costly corrective surgery, treatment for infections, and medical malpractice suits.

Furthermore, Massachusetts must act if it wants to remain a state that can justifiable claim to lead the national discourse on health care reform. The federal government and an increasing number of states and local governments are taking steps to better monitor and reduce HAI and medical errors. 

• In recent months, Medicare has announced that it will no longer reimburse hospitals for the treatment to correct certain medical errors. 
• Additionally, 17 other states already have laws that require public reporting of infection rates, among these are Connecticut, Colorado, Illinois, New Hampshire, Pennsylvania, Virginia, Vermont, Washington are among those states to implement public reporting of HAIs. 
• Finally, this week, the New York City Health and Hospitals Corporation, the nation’s largest public health system, begin to post its infection and death rates on the internet.

Each of these entities has rightly recognized the public health and financial benefits in reducing preventable adverse medical outcomes. Medicare is using government reimbursements to reward hospitals for reducing preventable medical errors and the states and the City of New York are empowering individual consumers to do the same. To strive for the highest quality of health care and to help reduce costs, Massachusetts must act now. 

Hospitals, too, have acknowledged the value of reducing medical errors and HAIs. 74 acute care hospitals across Massachusetts have signed up for the Institute of Health Care Improvement's new “5 million Lives Campaign”. As part of this campaign, these hospitals commit to implementing best practices to reduce preventable medical errors and HAIs. Through this program and other efforts, Massachusetts’s Hospitals have publicly announced their intentions to reduce the rates of HAI and medical errors and many have implemented innovative programs to meet this pledge. This legislation, with its reporting mechanism, would simply add public accountability to these efforts and further encourage hospitals to remain true to their HAI and medical error reduction commitments.

MOVING FORWARD

The Department of Public Health, in conjunction with the Quality and Cost Council and the Betsy Lehman Center, has developed a series of comprehensive recommendations for an HAI reporting system. These recommendations call for an incremental, measured and fair rollout of an HAI reporting system using an existing federal database. They are recommendations that, if implemented, regardless of legislation, will be solid steps toward creating a safer, more transparent health care system in Massachusetts. 

However, these recommendations and their proposed rollout through regulation do not negate the need for strong infection reporting legislation. Though I am very pleased with the work of Commissioner Auerbach and his staff at DPH and that of the Quality and Cost Council, codifying a reporting program in statute will protect their hard work from a potential future less forward thinking administration. 

As this bill and my other HAI and medical error reporting bills, S. 1269 & S. 1271, move through the Legislature, I am ready to work with the Committee on Public Health and DPH to create an HAI / medical errors reporting statute that allows DPH the flexibility to implement a policy based on the most current scientific data and available technology, but one that simultaneously brings more transparency to our health care system, gives consumers the tools they need to make informed decisions about where to receive their care, and, in so doing, encourages every hospital in Massachusetts to reduce its rate of medical errors and HAIs to as close to zero as possible.

Thank you.

• An Act to Promote Healthcare Transparency and Consumer-Provider Partnerships
  Text of S. 1269 | Status

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