Employers Unite to Tackle Medical Errors

Medical errors are an important consumer issue ripe for pandering to those who use health care the most: our elder generation. The button on this one doesn’t get any hotter.

According to a report from the Institute of Medicine (IOM), released late last year, as many as 98,000 Americans are dying each year as a result of medical errors. Former President Clinton and Congress jumped on the issue quickly, putting other issues like medical privacy and Medicare reform on hold. The result was a slew of executive orders, new legislation, increased spending, and growing medical bureaucracies.

Senate hearings were held, bills were introduced, and at least one measure has been passed and signed into law. Thirty-two states introduced legislative measures related to medical errors in 2000. California, New York, South Dakota, and Washington enacted laws. Tens, and eventually hundreds, of millions of dollars, according to one New York Times story, will be committed to implementing medical errors legislation.

Unreliable Data

The IOM report uses stale data from two relatively small empirical studies, one from Colorado-Utah and one from New York. The Colorado-Utah study was conducted nearly a decade ago, in 1992.

The IOM extrapolates estimates from the Colorado-Utah data and claims there might be 44,000 deaths a year nationally from medical errors. Using the New York data, the IOM claims the national death rate could be as high as 98,000 deaths a year.

Seeking Market-based Solutions

In response to the realities of preventable medical errors, The Business Roundtable (BRT) has launched an effort to improve patient safety across the nation.

The new initiative is called “The Leapfrog Group,” a growing consortium of Fortune 500 companies and other large private and public health purchasers. The Leapfrog Group is currently comprised of nearly 60 members, who provide medical benefits to more than 20 million American employees, who in turn spend more than $40 billion a year on health care services.

Under Leapfrog, employers have agreed to emphasize patient safety in their purchases of health care. Among the measures employed by the Leapfrog participants are:

Computer Physician Order Entry (CPOE) – CPOE allows physicians to enter medication orders via computer-linked error prevention software. Studies show the CPOE system can reduce prescription errors in hospitals by more than 50 percent.

Evidence-based Hospital Referral – By referring patients in need of complex medical procedures to hospitals offering the best survival odds, health care providers can reduce patients’ risk of dying by at least 30 percent.

ICU Physician Staffing – Intensive Care Units staffed by physicians with credentials in critical care medicine have been shown to reduce the risk of dying in an ICU by about 10 percent.

According to research conducted by John D. Birkmeyer MD, of the Dartmouth Medical School, these three patient safety-oriented measures can save as many as 58,000 lives a year and prevent 522,000 medication errors.

Members of the Leapfrog Group have also agreed to:

• educate and inform enrollees about patient safety and the importance of comparing provider performance.

• recognize and reward health care providers for major advances in protecting patients from preventable medical errors.

• hold health plans accountable for implementing the Leapfrog principles.

• build support for the Leapfrog initiative among health benefits consultants and health insurance brokers, who can advocate for the Leapfrog principles with all their clients.

Lewis B. Campbell, chairman and CEO of Textron and chairman of the Business Roundtable’s Health and Retirement Task Force, stated in a recent press release,

“Coming together with other employers through the Leapfrog Group, we feel confident in our ability to make a difference by harnessing and leveraging our health care purchasing power. It’s a straightforward business approach to tackling a complex problem—one that we must undertake to ensure our employees, retirees, and their families receive the highest quality and safest care available.”

Making a Difference

The IOM report serves an important purpose by reminding us of the precarious balance between desired medical outcomes and an acceptable level of failed outcomes. Unfortunately, the political and bureaucratic response to the report—tightening control over medical professionals by persons far removed from the front lines of medical care—may very well do more harm than good.

By contrast, the $40 billion spent on health care services by Leapfrog Group employees represents significantly more clout and potential for improvement than all the increased rules and regulations being issued by Washington bureaucrats.

For more information . . .

on the Leapfrog Group, visit The Business Roundtable’s Web site at http://brtable.org. Three documents there are especially useful: testimony by Dr. Arnold Milstein at http://www.brtable.org/document.cfm/372; and two news releases announcing the Leapfrog initiative’s launch at http://www.brtable.org/press.cfm/375 and http://www.brtable.org/press.cfm/464. Or contact BRT spokesman John Schachter at 202/872-1260.