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NYT on New Medical Mistake Reporting System

When a resident in Chicago or elsewhere in Illinois files a medical malpractice lawsuit they are seeking both redress for their individual harm and accountability to help others in the state.

It is self-evident that accountability for past conduct influences future conduct. Beyond med mal suits, another important accountability function involves public database and reporting systems. The more comprehensive the database, the better. There are clearly many good things that come from understanding how many medical errors occur, in what form, and where. However, patient safety advocates understand that we have a long way to go, because it is difficult to get these reporting protocols to be comprehensive. There are many incentives to underreport problems, and it is incredibly difficult to check the accuracy of the reporting.

New Medical Error Reporting System
It is under that rubric that the Obama administration is seeking to improve the reporting. A story in yesterday’s New York Times notes a new system that is striving to use patient reports on the care they received to identify problematic care. The idea is to use a consumer reporting system to identify potential problems in order to ultimately improve care.

Why go to patients?

Because it is unbalanced to rely only on hospitals, doctors, or other medical professionals to report their own misconduct. The idea is that there is a wealth of information about infections, surgical errors, medical problems and more that can be pulled from talking to patients themselves. As lawyers who work with patients following these mistakes, we wholeheartedly endorse the need to take personal patient experiences as a key tool in safety improvement efforts.

According to the story, the centerpiece of the new federal program is a simple questionnaire that asks patients about their medical care experience and asks for information about the health care providers involved. Patients then explicitly give access for the information to be sued in safety improvement efforts.

The Obama administration’s proposal is to make it as easy as possible for patients to contribute details about their care. The proposed reporting system would allow individuals to share their story via an online website or over the telephone. Beside sharing information about the possible problem, the questionnaire also seeks to understand how the problem might have occurred. For example, questions are asked about potential communication problem, insensitivity to race or culture, lack of basic empathy, ignorance of past medical treatment, and more.

Nothing about this seems all that revolutionary. Which is itself a reminder of the fact that patient safety efforts have often taken a backseat to cover-ups about medical errors. As the director of the Agency for Healthcare Research and Quality explained that, “Currently there is no mechanism for consumers to report information about patient safety events.”

Medical organizations have thus far reserved specific judgment on this patient survey idea. Some have welcomed the idea of more input while others have voiced concerns that patients might mischaracterize adverse events. But there seems little harm in at least collecting information to add to our overall understanding of the scope, type, and location of various medical misconduct problems.

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