State's Hospitals to Report Infections to Public

The law, passed last June, adds New Hampshire to a list of 15 states that mandate reporting of hospital infections.

These aren’t infections that send you to the Hospital.

These are infections patients get IN the hospital.

If all goes well, consumers will be able to get online and see infection data from all of the state’s hospitals.

But to get that website up and running, someone has to collect, store, analyze and present the data to the public.

And they have to use a format that makes sense.

The law assigns that task to the department of health and human services.

But lawmakers have not yet funded the system.

Greg Moore, a spokesman for the health department, said he doesn’t know if the new state budget will include funding for it.

And Jose Montero, the agency's epidemiologist, emphasized that the new process will require more than bean counting.

MONTERO: We don't want information that will sit in a bucket. To give it purpose we need people who can work on it.

And the lack of resources isn’t the only challenge.

Rachel Rowe, with The New Hampshire Hospital Association, warns that comparing hospital infection rates is risky.

As an example, she points out that patients can develop infections from hospital germs AFTER they leave the hospital.

And those infections may never be counted.

“It’s an enormous challenge to get the best possible information to the most appropriate audience in a suitable format with assurance that it is accurate and reliable. And the risks are huge unless it is done right.”

But Rowe added that New Hampshire’s hospitals support transparency – and that some are publishing patient outcome data now.

ROWE: We support this and we are ready to submit our data as soon as the department of health and human services, whom I hope you speak to, will give us definitions and methodology and criteria and how we should submit it. We will do that.

The health department plans to write the criteria – or rules - once they receive recommendations from CDC on how to collect and report the data.

That might happen by April, says Denise Graham.

She is the Senior Director of Public Policy at APIC - or the Association for Professionals in Infection Control and Epidemiology.

APIC led the effort to develop a standard or model for states to use to develop public reporting systems.

And advisors from CDC, hospitals and other health organizations joined APIC in the year-long effort.

The group analyzed many kinds of issues – including how best to collect, present and compare hospital infection data, Graham said.

Graham: By having all experts at the table they were able to identify different types of surgical procedures and specific categories of infections that can be reported to the public now - in a uniform way.

Graham believes that states should also collect quality measures from hospitals, such as employee hand washing and flu vaccination rates.

New Hampshire's law calls for reporting of infections, some quality measures, and the agents that cause the infections.

So infectious agents such as MRSA, one of the so-called superbugs, MAY be reported to the public.

MRSA is resistant to most antibiotics and is gaining ground at hospitals – causing infections from rashes to life-long illnesses or even death.

But DHHS said that until they write the final rules – it is unclear whether MRSA and other drug-resistant agents will be included on the website.

Right now, hospitals don't have to report MRSA infections to the state - nor to the agency that oversees Medicaid and Medicare - CMS.

And some hospitals complain that patients shouldn’t use that type of data to choose a hospital because they won’t understand it.
But APIC’s Graham disagrees.

Graham: People are - we are undermining their intelligence by saying they won’t understand the number. Let’s educate them. Maybe part of reporting on behalf of the states is to compile a mini-eductaion campaign when you’re going to look at this information – understand what is involved. What’s really behind that number.

And Graham says that hospital CEOs may soon have more incentive to focus on agents that cause infections - including MRSA.

Graham: I feel comfortable that the administrators will begin to take a better look at this since two years from now the Centers for Medicare and Medcaid will be linking payment to performance.

Centers for Medicare and Medicaid ruled that by 2008 hospitals will no longer be paid for “avoidable” infections at hospitals.

But – the definition of an “avoidable” infection is still under debate.

And some of the contents of New Hampshire’s new reporting law appear to be disputable.

For NHPR News, I'm Dianne Finch