HVA: Solution to the Medicare Solution

Interesting feedback in the March 7th Ann Arbor News article titled "Medicare Plan May Backfire in its results, Penalizing of hospitals is overly punitive". According to the piece:

"Come October, Medicare will stop paying hospitals for certain medical mistakes. The plan is not unreasonable. However, the list of mistakes that will no longer be reimbursed might go too far.

Few medical providers would quibble with not being paid for serious errors such as operating on the wrong limb, leaving sponges or other surgical equipment inside a patient's body or using the wrong blood type. But not being paid if a patient gets a bed sore or suffers a fall seems overly punitive.

Given the patient population served by Medicare - the elderly and disabled - it's impossible to believe that every fall or bed sore can be prevented. That could require increased staffing to provide virtually 24-hour monitoring for some patients prone to bed sores or who have balance issues. Or it could prompt more intrusive admission policies that require significant time and costs to identify pre-existing conditions before a patient is admitted.

Medicare plans to stop reimbursing hospitals for the care required to treat patients who: fall, get bed sores; get urinary tract or bloodstream infections from catheters; have objects left inside their bodies during surgery; get the wrong and dangerous blood type; get mediastinitis, which is an infection after heart surgery; or get air bubbles in a blood vessel."

With Medicare estimating that the government can save approximately $190 million over five years by not paying the extra costs of those 8 conditions--being they're deemed preventable medical complications--the thinking is to force the hospital's hand financially to improve patient safety and patient safety protocols.

Economic incentives, such as fines or refusing to pay (as with the Insurers) are effective, but so are better systems that are designed to prevent medical errors in the first place. This is where Hospital Video Auditing (HVA) can help--it gives 24/7/365 monitoring for many of the biggest culprits, like hand hygiene compliance and central line insertion. HVA also monitors for fall reduction and prevention.

The writer continues with, "Making hospitals absorb the cost of medical mistakes won't be a cure-all. Even with the best of care, accidents can and do occur in hospitals. Human error is a fact of life. Offering a carrot rather a stick might be a better option. Rewarding hospitals if they are under a certain level of errors might be a better remedy for reducing hospital errors."

This is yet another benefit to HVA--with a constant stream of data charting progress against protocols (see a sample report here), hospital administrators are able to set goals and publish consistent data on how the physicians are delivering against those objectives.

All told, it's up to hospital administrators to create a positive environment and use the reports as an incentive, but, in other safety-sensitive industries such as food processing and food preparation, managers have used the technology and service to reward employees (carrot) vs. penalize them (stick).

• Full article can be accessed here
• More on HVA available here
• FAQs available here