MARK B. MCCLELLAN, M.D., PH.D., CMS ADMINISTRATOR SPEAKS TO INSTITUTE OF MEDICINE REPORT
IN RESPONSE TO INSTITUTE OF MEDICINE REPORT ABOUT IDENTIFYING AND PREVENTING MEDICATION ERRORS
The Centers for Medicare & Medicaid Services appreciates the important findings of the Institute of Medicine ’s (IOM) Committee on Identifying and Preventing Medication Errors.
The report issued today, funded by CMS, found that errors in prescriptions and failures to prescribe prescriptions result in pain, suffering, and deaths, as well as billions of dollars of unnecessary expenses. It is a problem that affects all healthcare settings and services, including hospitals, pharmacies, doctors offices, nursing homes, and home health – a problem that HHS is focusing much of its attention on resolving.
To realize the promise of 21st Century healthcare, where quality of care is the right care for every patient every time, we must utilize innovations in technology, in treatment and in quality to transform care delivery systems so they are safe, as well as sustainable and affordable. Our vision for the future is this high-quality care system; a system that empowers patients and their health care providers to make the best decisions and get the best possible care. That requires government, industry, providers and practitioners alike in responding and meeting the demands for quality care and providing it.
The IOM recommendations underscore the important role government has in providing its resources to raise the standards in addressing the problem. CMS has begun implementing the e-prescribing provisions of the Medicare Modernization Act by issuing standards that help to ensure consistency and efficiency in prescribing drugs as part of the Medicare prescription drug benefit. In addition, CMS is:
- Conducting e-prescribing pilot projects to improve patient safety, improve the efficiency of providing prescription drugs and using electronic messaging standards to ensure that pharmacists and physicians and their staffs have the information they need about a patient’s history;
- Requiring Medicare prescription drug plans to support e-prescribing standards for use by those providers who prescribe drugs for beneficiaries electronically, once national standards are issued;
- Issuing a final regulation in the very near future to promote the adoption of electronic health records with e-prescribing by providing for exceptions under the physician self-referral statute and the anti-kickback statute to create a safe harbor for certain arrangements involving the donation of electronic prescribing and health records;
- Educating beneficiaries about the drugs they take, following a medication regimen for a specific condition, providing information about formulary-based drug coverage, including formulary alternatives and co-pay information, and speeding up the process of renewing medications by reducing the number of phone calls to the plans;
- Using drug data to identify safety problems and adverse events, including those needing nursing home or home care, enabling a new tool for efficient insight into prescribing practices, patterns of error, and potential efficiencies;
- Collecting data and publishing performance measures related to the effective use of medications, including 11 measures of care that directly measure correct medication use on www.HospitalCompare.hhs.gov;
- Working with local Quality Improvement Organizations to use medication reconciliation and focus on the reliability of transfers and handoffs from one care setting to another;
- Testing approaches to pay health care providers more for providing better quality care to Medicare beneficiaries, including more effective use of drug therapies; and
- Requiring survey and certification of nursing facilities to include substantial requirements to avoid misuse of medication, including preventing the overuse of psychoactive drugs.
But government cannot and should not address it alone. CMS and HHS are also enhancing potential public-private partnerships to improve drug safety for all Americans. We are actively engaged in a number of public-private partnerships, through which we have formed trusting relationships for building consensus about measurement and public reporting. Together we are building on collaborative relationships that help in supporting measurement and reporting of serious preventable errors, working to develop standard measures of care and encouraging the public reporting of information about unsafe patient care.