MEDICAL MISTAKES: Clinton Issues Mandates
Reacting to the report issued last week by the Institute of Medicine, President Clinton today will order federal agencies that provide or pay for health care to evaluate and implement methods for reducing medical errors, according to the New York Times. White House officials said the move is an attempt to use the purchasing power of the federal government, the nation's largest buyer of health care services, to force industry-wide reforms aimed at improving patient safety.
Medicare, Medicaid to Lead
Clinton's directive will require all private health plans that cover federal employees to adopt error-prevention techniques recommended by the IOM, including investigation and reporting of medical mistakes and systemized precautions against drug errors. The president also will instruct the federal departments responsible for Medicare, Medicaid and veterans and military health care to "evaluate and, where feasible, implement the latest error-reduction techniques," according to White House documents. Because Medicare and Medicaid account for a huge portion of hospital revenues, any standards adopted by the programs are likely to become "virtual mandates for the entire health care industry," the Times predicts (Pear, 12/7).
Budget Proposals, Legislation Expected
Clinton is not expected to fully endorse the proposals made in the IOM report, partly due to concerns about privacy of medical records; instead he will give an interagency task force 60 days to assess the "feasibility and advisability" of the Institute's recommendations, officials said (Goldstein, Washington Post, 12/7). The president is also expected to ask the agencies to transform their conclusions into proposals to be included in the FY 2001 budget submitted to Congress early next year (Gerlin, Philadelphia Inquirer, 12/7). On the legislative front, Sen. Edward Kennedy (D-MA) has said that he plans to introduce a bill, with bipartisan support, to implement all IOM recommendations, including the creation of a federal Center for Patient Safety and mandatory error-prevention programs for Medicare and Medicaid hospitals (New York Times, 12/7).
AHA, Premier Sponsor Initiatives
Officials said that Clinton will praise the American Hospital Association's plan to issue recommendations for tracking and preventing adverse drug events to its members (Philadelphia Inquirer, 12/7). Meanwhile, Premier Inc., an alliance of nonprofit hospitals, has launched its own collaborative effort to reduce ADEs. Its medication management initiative aims to develop a best practices model for ADE reduction and to introduce new bedside technology that verifies the correctness of medication before it is administered to a patient (Premier release, 12/6).