Consumer reporting system could come soon

Under a proposed federal reporting system, consumers could start reporting medical mistakes about hospitals, physicians, pharmacists and other providers. If the White House administration approves the pilot project, health officials could start collecting data as early as May 2013, The New York Times reported.

To be administrated at hospitals and doctors' office kiosks or through fliers at pharmacies, the questionnaire asks patients to identify the name and address of providers involved in medical mistakes, such as wrong-site surgery, drug mix-ups and radiation overdoses.

Although providers applaud patient safety initiatives, some worry the proposed reporting system could open up Pandora's box to malpractice liability and financial penalties for poor performance, although officials said they would keep the information confidential, the NYT noted.

Kevin J. Bozic, the chairman of the Council on Research and Quality at the American Academy of Orthopaedic Surgeons, said, "[P]atients may mischaracterize an outcome as an adverse event or complication because they lack specific medical knowledge." For example, a patient who sees a surgical wound appear red might misinterpret that as an infection.

The pilot reporting system could be "a great concept," as American Hospital Association Vice President Nancy E. Foster called it. It could be particularly beneficial for consumers because there isn't a current mechanism for reporting, according to Carolyn M. Clancy, the director of the federal Agency for Healthcare Research and Quality.

"Patient reports could complement and enhance reports from providers and thus produce a more complete and accurate understanding of the prevalence and characteristics" of medical errors, Clancy said.

Medical mistakes are far from rare, according to Johns Hopkins Hospital surgeon Martin Makary. Adding up the number of medical mistakes could fill up four jumbo jets per week, he wrote in a Wall Street Journal essay. Roughly a quarter of all hospitalized patients will be harmed by a medical error of some kind, he noted.

Makary suggested hospitals use cameras to prevent and record medical errors. For instance, Doug Rex, a gastroenterologist at Indiana University, started to record procedures before and after telling his partners in the practice. The average length of the procedures increased by 50 percent, and the quality scores by 30 percent. Recording procedures, such as cardiac catheterizations and arthroscopic surgery, could be used for peer-based quality improvement but also serve as a record.

"It may come as a surprise to patients, but doctors aren't very good at complying with well-established best practices in their fields," Makary said.

For more information:
- read the NYT article
- see the WSJ op-ed

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