About Health Transparency

The Department of Health and Human Services (HHS) plan to open up access to the public to their Medicare claims database. Specifically, Medicare will relax its restrictions on the release of information about individual doctors who participate in Medicare,  writes Wall Street Journal. Under the new rules, the agency is allowing a new category of organizations to obtain the data: community groups comprising doctors, health insurers, businesses, consumers and government that work to improve health care at the local level. These groups, which the agency estimates number about 25 nationwide, will be able to use the data to publish studies, such as report cards on certain procedures, hospitals or doctors. Although they will have to notify the subjects of their reports 60 days in advance, doctors won’t be able to block publication. Patient information will remain confidential.

Read full article: Access to widen on Medicare data, Wall Street Journal

A new report from the Consumer Reports Health Ratings Center found that pediatric ICUs often have higher infection rates than adult ICUs, and that some hospitals do much better than others at preventing infections. The report focused on central-line bloodstream infections, rating 92 pediatric ICUs in 31 states plus Washington, D.C., which publicly reported enough data for statistical valid assessments of their rate of bloodstream infections. Those infections are fatal in as many as one in four cases.

• Read report summary
• Read full report

The latest data update has been published on CMS Home Health Compare, reporting home health quality data for the time period October 1, 2010 through September 31, 2011.

Data has also been refreshed on CMS Hospital Compare as follows:

• Process of care measures reporting data from April 1, 2010 through March 31, 2011 for all measures except:
  • new heart attack measure – Statin Prescribed at Discharge -  reporting data for January 1, 2011 through March 31, 2011
  • PN 7 – Pneumonia Patients Assessed and Given Influenza Vaccination:  reporting data for October 1, 2010 through March 31, 2011
• Patient experience data (HCAHPS) updated, reporting data from April 1, 2010 through March 31, 2011
• Introduction of new hospital acquired infection measure – Central Line Bloodstream Infections – reporting data from January 1, 2011 through March 31, 2011)

Reporting time periods for the following measure sets remains unchanged from previous data refresh on CMS Hospital Compare:

• Mortality and readmissions measures, reporting data from July 1st, 2007 through June 30th, 2010

• Medicare reimbursement & number of cases measures, reporting from October 1, 2009 through September 31, 2010
• Patient safety and hospital acquired conditions measures, reporting from October 1, 2008 through June 30, 2010

Minnesota Department of Health has released its annual report on adverse health events in Minnesota. The legislation creating the adverse health events reporting system was championed by Minnesota hospitals and signed into law in 2003.  The law requires all Minnesota hospitals and ambulatory surgical centers to report 28 types of serious events to the Minnesota Department of Health.

Based on a list of reportable adverse events created by the National Quality Forum, in 2010, Minnesota hospitals reported about 2.6 million patient days and more than 10 million outpatient registrations. Ambulatory surgical centers reported more than 216,000 registrations for same-day surgeries.

A full copy of the report (Adverse Health Events in Minnesota, Annual Report January 2012) and additional information can be found on MDH’s Adverse Health Events Web page, at www.health.state.mn.us/patientsafety.

Thomson Reuters released its annual study identifying the 100 top U.S. hospitals based on their overall organizational performance, including patient care, operational efficiency, and financial stability. The Thomson Reuters 100 Top Hospitals study compares hospitals only against similar facilities in terms of size and teaching status.  It evaluates performance in 10 areas: mortality, medical complications, patient safety, average patient stay, expenses, profitability, patient satisfaction, adherence to clinical standards of care, post-discharge mortality and readmission rates for acute myocardial infarction (heart attack), heart failure, and pneumonia.

Download the Thomson Reuters Top 100 Hospitals study overview and research findings (pdf)

The Affordable Care Act requires the Secretary of the Department of Health and Human Services to identify and publish a core set of health quality measures for Medicaid-eligible adults. This background report documents the process, deliberations, and results of AHRQ’s National Advisory Council Subcommittee for Identifying Health Care Quality Measures for Medicaid-Eligible Adults.

Read full background report

Indiana State Department of Health released the Indiana Medical Errors Reporting System Final Report for 2010.  This is the fifth Indiana Medical Error Report and presents information about reportable events occurring in Indiana health care facilities between January 1, 2010 and December 31, 2010. The Indiana Medical Error Report for 2010 is based on data received by the Indiana State Department of Health prior to August 1, 2011.

Indiana’s Medical Error Reporting System requires that hospitals, ambulatory surgery centers, abortion clinics, and birthing centers report any reportable event that occurs within that facility. For 2010, there were a total of two hundred and ninety-five (295) facilities required to report. One hundred and seven (107) events were reported for 2010. One hundred and two (102) events occurred
at hospitals while five (5) events occurred at ambulatory surgery centers.

The one hundred and seven (107) reported events for 2010 is an increase from the 94 events reported for 2009. The number of events is the highest in the five-year history of reporting but only slightly higher than the 105 events reported in 2007 and 2008. The most reported event for 2010 was stage 3 or 4 pressure ulcers acquired after admission followed closely by retention of a foreign object in a patient after surgery.

Read full report: Indiana Medical Errors Reporting System Final Report for 2010 (pdf)

The California Department of Public Health (CDPH) released six reports with data collected from California’s hospitals on certain types of healthcare-associated infections.   The collecting and reporting of data on healthcare-associated infections (HAI) enables hospitals to identify areas for improvement, healthcare purchasers to determine the value of care, and patients to make more informed choices.

The reports provide data from California’s hospitals for the following types of infections: Central-line associated bloodstream infections (CLABSI); Clostridium difficile infections (CDI); Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) bloodstream infections; Surgical site infections (SSI). A fifth report examines hospital use of practices to prevent specific infections, known as central-line insertion practices (CLIP), and a final report provides rates of influenza vaccination among hospital workers.

Highlights from the reports include:

• Central-line associated bloodstream infections (CLABSI)—Half of all hospitals providing critical care to infants reported none of the infections in those patient care locations. This year’s report is the first in California to provide CLABSI rates for specific patient care locations within hospitals.
• Clostridium difficile infections (CDI)—Long-term acute care hospitals have infection rates that are more than twice those of general acute care hospitals, most likely because patients stay longer in long-term care facilities.
• Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)—Forty-nine percent of the hospitals reported no MRSA and 59 percent reported no VRE. These infections occur primarily in severely ill patients. Rates of MRSA and VRE were significantly higher in major teaching and long-term acute care hospitals, where more severely ill patients receive care, than in pediatric hospitals and community hospitals.
• Central-line insertion practices (CLIP)—In 93 percent of the instances in which these infection prevention practices were required, hospital staff did so.

California hospitals are now required to report Surgical Site Infection data electronically through the federal National Healthcare Safety Network (NHSN), effective April 1, 2011. A smaller report using NHSN data, covering April through June, 2011, was included in those released.

Data on healthcare worker vaccination practices, which was released in December  2011, show that the influenza vaccination rate for hospital employees was 64.3 percent in 2010-11, a slight increase from the rate of 62.6 percent in 2009-10.

In all of the reports but one—healthcare worker vaccination—hospitals used the NHSN reporting system for the first time. In addition, the report on CLIP was the first of its kind.

The series of reports are mandated by SB 1058 (Chapter 296, Statues of 2008). Hospital compliance with providing data for the reports for 2010-11 ranged from 91 percent to 98 percent. To promote compliance, CDPH conducts a quality assurance process that ensures that hospitals are aware of missing or unreported data, provides assistance in correcting deficiencies and offers educational opportunities and individual onsite consultation to assist hospitals in reporting compliance.

Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report, writes New York Times.Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the “adverse events,” according to the study, from Daniel R. Levinson, inspector general of the Department of Health and Human Services.

Read full news item: Report Finds Most Errors at Hospitals Go Unreported