A patient-safety bill approved last week by a Senate panel would not punish providers for reporting medical errors, but might require new investments in information technology that it would not help hospitals fund.
The Senate Health, Education, Labor and Pensions Committee unanimously passed the bill that would set up a voluntary system for providers to report medical errors without fear of punitive action.
A similar proposal passed the House in March, and Senate Majority Leader Bill Frist (R-Tenn.) said he would bring the Senate version to the full chamber "as quickly as possible." The bill, Frist said, would "revolutionize the practice of medicine in a positive way."
The bill isn't likely to be considered further until Congress returns from its August recess.
Since 1999, the Senate has debated various versions of patient safety legislation but got hung up on a mandatory versus voluntary system and other disagreements.
The health committee's passage of a bill last week "is a real breakthrough for the Senate," said Herb Kuhn, vice president of advocacy for the Premier hospital alliance in Washington.
Under the Senate's bill, new public or private "patient-safety organizations" would collect and analyze voluntary error reports from providers. Then, under the direction of the Agency for Healthcare Research and Quality, the safety groups would create a national database to store the information and use it to improve overall quality.
As hospital and physician groups expressed support for the Senate measure, some also said they're concerned that the information technology required to process and analyze clinical data is still insufficient or too expensive for many providers to obtain.
Encouraging providers to invest in error-reducing information technology-such as physician order entry and electronic prescriptions-is "one of the most important steps we can take to protect the safety of patients," Sen. Christopher Dodd (D-Conn.) said in remarks to the committee before it passed the bill.
Dodd had planned to introduce an amendment to the bill that would provide seed money for hospitals and other providers to begin making more substantial investments in information technology. Knowing his amendment would fail in the Republican-controlled committee, however, he decided to withdraw it and hopes to add the technology provisions when the bill gets to the Senate floor, Dodd said.
Information technology is an "absolutely critical" part of improving patient safety, said William Jessee, president and chief executive officer of the Medical Group Management Association in Englewood, Colo. However, he added, because Medicare pays doctors the same rate it did in 1998, "you won't see a lot of physicians running out to invest in IT."
Although the error-reporting system described in the bill would be voluntary and would not impose penalties on those who commit or report errors, some committee members said they worried about caregivers hesitating to come forward. "We need to be careful we're not using information to punish people," said Sen. John Ensign (R-Nev.).
The legislation has two goals, according to Sen. Judd Gregg (R-N.H.), including protecting the rights of patients harmed and using information gleaned from errors to "avoid that type of harm or injury in the future."
The voluntary, nonpunitive approach "is very much oriented toward creating a learning environment where caregivers can more freely share information," said Anne Ubl, a legislative analyst at the American Hospital Association, which endorsed the Senate bill.
Under the Senate bill, the HHS secretary would lead efforts to create information systems that can operate on the same platform to ease the exchange of quality information across the industry.
"That has to be done before it makes good sense to invest in these systems," Ubl said, adding that "learning what went wrong does not depend on IT."
Lobbyists expected the Senate's patient-safety bill to have little problem passing the full Senate, especially because it now enjoys the support of Sen. Edward Kennedy (D-Mass.), who earlier had concerns about parts of the proposal.