A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

HCFA’s 2009 Legislative Agenda - Parts 3 and 4

HCFA’s 2009 Legislative Agenda - Parts 3 and 4

January 21, 2009

Over the next few days, HCFA will be highlighting legislative agenda. Parts one and two covered children's health and health reform. Our second installment covers quality, electronic health privacy, and disparities: Improving Quality and Advancing E-Health The Consumer Health Quality Council, in partnership with Health Care For All, has worked with legislators to file three healthcare quality improvement bills. The bills seek to decrease healthcare-associated infections, prevent medical errors, and reduce medication errors. Below is a summary of each bill:

  1. Reduce Healthcare-Associated Infections - In 2005, 19,000 people in the United States died from a Methicillin-Resistant Staphylococcus Aureus (“MRSA”) infection. A 2007 study found that hospitals nationwide would save over $231 million annually if all elective surgery patients were screened for MRSA upon admission and proper precautions were taken with those found colonized with MRSA. California, Illinois, New Jersey and Pennsylvania have all passed laws requiring hospitals to screen patients for MRSA. This bill seeks to reduce healthcare-associated infections by requiring healthcare facilities to screen high-risk patients for MRSA upon admission and take precautions, such as strict hand-hygiene practices and isolation of patients, for those who test positive. Healthcare facilities would report data about MRSA to the Department of Public Health and the Betsy Lehman Center for Patient Safety and Medical Error Reduction. The lead sponsor for the bill is Representative Denise Provost.
  2. Use Checklists To Improve Care - Medical errors injure approximately 1 million Americans each year during the course of their hospital stay and up to 100,000 die as a result. In July of 2008, an experienced surgeon at a Beth Israel Deaconess Medical Center operated on the wrong side of a patient, a serious medical mistake that could have been avoided if a checklist of care had been used. President and CEO of Beth Israel, Paul Levy, recently endorsed the use of a checklist in his blog. Had there been a checklist prior to the surgery, the medical error at Beth Israel could have been prevented. A recent study, discussed in a recent HCFA blog found that a surgical checklist reduced surgical complications and deaths by 36%. This bill seeks to reduce medical errors and infections in hospitals through the use of “checklists of care,” a series of steps to be regularly taken by teams of healthcare providers to decrease patient harm for given procedures. The bill requires the Department of Public Health to develop checklists of care for use in hospitals. DPH may require hospitals to report on their use of checklists. The lead sponsor for the bill is Representative Denise Provost.
  3. Reduce Medication Errors in the Commonwealth - According to the Institutes of Medicine, there are at least 1.5 million preventable adverse drug events (injuries caused by medications) per year in the United States. The occurrence of adverse drug events in hospitals costs about $3.5 billion per year. This bill requires the Department of Public Health and the Betsy Lehman Center for Patient Safety and Medical Error Reductions to convene an expert panel to study medication errors and their occurrence in Massachusetts. The expert panel shall make recommendations for steps to be taken to decrease medication errors across all healthcare settings. Lead sponsors for the bill are Senator Susan Tucker and Representative Kay Khan.

For more information about the legislation, contact Deb Wachenheim (dwachenheim@hcfama.org or 617-275-2902). To learn more about the Consumer Health Quality Council , contact Kuong Ly (kly@hcfama.org or 617-275-2940). To make sure that Chapter 305, the Cost Containment Bill, has robust privacy protections for the electronic health records and interchanges that it requires, the ACLU of Massachusetts and HCFA (working closely with AIDS Action) have drafted An Act to Clarify and Enhance Privacy Protections for Electronic Health Records. Chapter 305 already has some excellent privacy provisions, but there are gaps, as well, that need to be filled. To close these gaps, this act will:

  • Require providers and organizations receiving money from the E-Health Institute Fund to conduct annual privacy and security audits of their electronic health records systems;
  • Create a mechanism to address violations of patient privacy; and
  • Establish explicit protection from retaliation for employees who report privacy and security violations.

In order for electronic health records to live up to their promise of enhancing efficiency, effectiveness, and engagement, consumers and providers alike must trust the system. These provisions will go a long way toward building that trust. Ending Health Disparities The Disparities Action Network (DAN) has partnered with Senator Fargo and Representative Rushing to file two pieces of legislation aimed at reducing health disparities in the Commonwealth. In a continued effort to broaden the discussion on health disparities and advance policy that supports health equity; the coalition is supporting two bills to

  1. codify the EOHHS Office of Health Equity in statute; and
  2. establish a community-based disparities grant program.

The two bills provide the state with a stronger infrastructure to lead and coordinate disparities efforts, while supporting local communities to implement programs and best practices. Despite the expansion of healthcare access, Massachusetts residents of color continue to face disproportionately higher rates of chronic illness and mortality than residents of the state as a whole. This inequality is costly for both the healthcare system and impacted populations. Health equity is one of the key health policy issues for Massachusetts to move forward, and the next frontier of health reform. The DAN will continue to build a movement to address the complex issues that influence health inequality, in effort to improve healthcare access and quality for underserved communities, reduce healthcare costs for the system, and achieve fairness and equity for all. For more information, contact Camille Watson (cwatson@hcfama.org).