From the GIC Winter 2001 Newsletter pdf format of fybwinter2001.pdf

Starting in July 1, 2001, all GIC health plans began reporting patient safety information on key indicators established by the Commission. At the Commission meeting in October of that year, the Commission voted to require plans to provide information relating to hospital-based safety measures. We will eventually provide this information to you to assist you with your health care decision making.

In late 1999, the Institute of Medicine (IOM) reported that 44,000 to 98,000 Americans die each year as the result of preventable medical errors. Using the IOM's most conservative number, medical errors are the eighth leading cause of death, killing more Americans than automotive accidents. Extrapolating from these numbers, 33 to 89 state employees, or their family members, die annually from preventable medical errors.

As one of Massachusetts' largest health care purchasers, we are taking a leading role in tackling this problem. The GIC adopted standards for the new health plan contracts that will begin in July 2001, corresponding to those developed by the Leapfrog Group, a national coalition of large employers who are addressing patient safety. "These standards save lives," said Dolores L. Mitchell, GIC Executive Director. "We have an obligation to our enrollees, and the citizens of the Commonwealth to take a stand now, rather than later."

Beginning with the FY '02 fiscal year, GIC health plans will provide data to track the following three standards:

Computerized physician order entry of prescriptions in the hospital: As described in the IOM"s "To Err is Human", 7000 people die each year as the result of medication errors. More than one million medication errors occur every year in U.S. hospitals according to the Leapfrog Group. Computerized medication ordering (CPOE) has been shown to reduce serious prescribing errors by more than 50 percent. A Leapfrog Group study estimates that implementation of CPOE systems at all non-rural hospitals could prevent over 500,000 serious medication errors each year.

Physician Staffing in Intensive Care Units (ICU): ICUs and operating rooms are the highest risk areas in hospitals: 500,000 patients die in ICUs each year according to the Leapfrog Group. They estimate that ICU staffing by physicians certified in critical care medicine can reduce ICU mortality by 50,000 in metropolitan areas alone.

Hospital volume for seven complex treatments: Obtaining care for certain high risk procedures at hospitals that are not experience in handling them increases a patient's risk of dying by 26%, according to a 1999 study published in the New England Journal of Medicine. The following are the procedures that GIC's health plans will track by hospital by volume:

  • Coronary artery bypass
  • Coronary angioplasty
  • Abdominal aortic aneurysm repair
  • Carotid endarterectomy
  • Esophageal cancer surgery
  • Delivery with expected birth weight under 1500 grams or gestational age under 32 weeks
  • Delivery with pre-natal diagnosis of major congenital anomalies

In addition to saving lives, these initiatives also lower health care costs. The IOM reported that medical errors cost the nation's health care system an estimated $8.8 billion annually. A 1996 Brigham and Women's Hospital study indicated that preventable adverse drug events occur in nearly two percent of its admissions. Added costs of $4500 per event result from longer stays and additional treatment. To its credit, the hospital has made great strides in installing CPOE error-prevention systems described above.

This information provided by the Group Insurance Commission .