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Health Care Data Access, Quality & Safety Improvement NBCH Policy Statement August 2005
The National Business Coalition on Health (NBCH) strongly believes that fundamental to the success of provider care improvement is the commitment to continuous quality improvement by all stakeholders through standardized assessment of performance, delivery of evidenced-based care and reward of improved performance. Key to this effort is continued progress in the collection and distribution of health care data. Currently, there is an overwhelming need for a national framework for voluntarily reporting data, which up to this point, are typically developed locally.


NBCH is pleased with the recent efforts in Congress and by the President to enact legislation to create a national framework through a voluntary provider reporting system. However, NBCH is concerned with the fast legislative pace by which this issue was addressed in Congress. Without detailed consideration given to important components, there may be serious, unintended consequences, namely eliminating public access to data about physician care.


The newly enacted law, PL 109-41, works toward the vital goal of including providers in the error prevention process, namely by encouraging them to voluntarily report medical error information to certified patient safety organizations (PSOs). Obviously, to encourage providers to voluntarily report mistakes, the bill must grant providers liability and confidentiality protections for the information submitted to the PSO.


In concept, this is a positive step toward creating an environment conducive to voluntary reporting, as well as encouraging the establishment of PSOs. However, it is important that legislation does not jeopardize the ability for employers, business coalitions and consumers to continue to access provider level data. These constituencies have a long history of working cooperatively with providers on quality improvement issues, and with the right data collection and reporting tools and resources in place, these groups want to work with all providers to improve the operation of their practices and the care they provide.


In fact, business coalitions have been quite effective in a variety of grassroots quality improvement efforts due to their ability to coalesce the action of many employers, which is a key component to creating market incentives for improved health care quality and value. Business coalitions can have a strong impact in their markets and, in turn, can be instrumental in encouraging data reporting, collecting and analysis methods rewards performance-focused activities. However, to continue to truly impact the quality of care given by providers, business coalitions, employers and consumers need to have as much information as possible about individual and group physician practices.


NBCH is concerned that information now publicly available, either voluntarily or through operation of federal, state or local requirements, would be shielded from public access by the new patient safety reporting law. The most important point on this issue is that only information collected and developed by a provider solely for reporting to a PSO should be protected from public disclosure. Additionally, all future data must be available for public access upon government or purchaser request. On a similar issue, legislation should not preempt or limit any existing or future federal, state or local reporting requirements.


As the Department of Health and Human Services works to implement this new national, voluntary provider data reporting system, NBCH hopes that these concerns are taken into consideration. Provider data is very powerful information if it is used correctly and very dangerous and misleading if it is not. Transparency, disclosure of and access to provider level information is absolutely essential to business coalition and employer efforts to improve health care quality, to conduct value-based purchasing, and to provide consumer education and choice.