Congressman Patrick Kennedy submits 'Josie King' patient safety bill

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Congressman Patrick J. Kennedy (D-RI) on Wednesday introduced the "Josie King Act" (also known as the "QUEST Act"), named for an 18-month old girl who died as a result of preventable medical errors. The bill looks to establish regional health information networks for sharing of secure data among providers and patients and transform the technological backbone of the American healthcare industry by 2015. A fully electronic health information system would be in place in a decade.

The announcement coincided with the National Health Information Infrastructure conference, taking place in Washington this week. Kennedy's bill is the only comprehensive proposal currently before Congress to address this need, his office said.

The bill will enable clinical IT systems to allow higher quality, better patient safety, and increased efficiency, Kennedy said.

"Our healthcare system failed Josie King, as it's failed so many people," Kennedy said. "As incredible as our medical care can be, structural flaws in our healthcare system cost tens of thousands of lives and hundreds of billions of dollars each year.

"Information technology is the means, not the end," Kennedy said. "The end is better clinical outcomes for patients at lower cost."

The Josie King Act also will dramatically increase research into best medical practices and methods to take advantage of the data available through clinical IT systems. It will also create standardized measures of provider performance and annual public measurements that could serve as the basis for new "pay-for-performance" initiatives.

Last month, Kennedy held the "Frontiers of Healthcare" conference at Brown University in Providence to delve into strategies to transform healthcare quality and efficiency. Kennedy incorporated refinements into the legislation as a result of the discussion that occurred there, including: a new scholarship program to create a cadre of healthcare leaders with the skills and orientation to promote a relentless drive for higher quality at lower cost; a new Center for Clinical Decision-Support Technology, to improve the integration of medical knowledge into computerized clinical information systems; and provisions to assist physicians in re-engineering how they deliver care to maximize the benefit of new technologies and processes.

The act would also institute a number of structural changes to the manner in which providers practice medicine that would: reduce duplication, eliminate errors, foster establishment of and adherence to best practice guidelines for providers, give public health agencies a way to rapidly detect and respond to bio-terrorism threats, provide data to measure and repair provider performance, and cut down on administrative costs such as transcription and billing.

Kennedy also pointed out a number of harrowing statistics:

  • Fragmented information: 20 percent of tests and labs ordered because previous results were unavailable;

  • Frequent errors: as many as 98,000 deaths in hospitals per year due to preventable errors;
  • Missed opportunities: evidence-based medicine used only 55 percent of the time;
  • Archaic platform for state-of-the-art medicine: less than 5 percent of doctors use electronic health records; relative IT spending in healthcare is less than one-third of banking;
  • High price tag: Waste, error, and duplication accounts for 30 cents on the dollar, totaling a $515 billion tax on employers and individuals.

Kennedy praised Brailer's "progress report," but added: "David Brailer has done a great job laying out goals for our healthcare system, but we need more. The report is a good first step, but we need a concrete plan for how to accomplish the goals we all agree on, and I think this legislation helps point the way."