NM to start reporting hospital-acquired infections publicly

Later this year New Mexico will start a public website to display the number of infections patients contracted at several medical facilities around the state.

The website won’t break down the infection rate by facility. That comes in July 2011, when the state will begin to post such data on several infections, meaning the public could compare how careful — or careless — hospitals and medical centers are in preventing — or allowing — sometimes deadly infections.

The catch: hospitals won’t have to share the data if they don’t want to on certain types of infections.

Unlike some states, including Colorado, New Mexico has no law requiring hospitals to publicly report rates of hospital-acquired infections even as the state is looking to expand the number of infections it tracks. And while a new federal rule issued recently requires hospitals to report to the federal government, the mandate only applies to one type of commonly contracted infection at hospitals and medical centers.

So the only data appearing on the state’s public portal once it is up and running will come from facilities volunteering the information, a state official said Tuesday.

“They would have to pass a law” to require hospitals to share that information, said Deborah Busemeyer, a spokeswoman for the New Mexico Department of Health.

Busemeyer, the health agency spokeswoman, pointed to the increase in hospitals and medical facilities voluntarily releasing the data to the state as evidence that hospitals and medical centers would continue to share the information.

“There’s been a lot of interest,” Busemeyer said. “We started with six hospitals. Now we’re up to 25.”

According to the website of the New Mexico Hospital Association, there are more than 40 hospitals and medical centers in the state.

One state lawmaker believes that New Mexico should be lauded for the progress it has made, but it isn’t where it should be in making such information public.

“I’m pleased that they’re moving forward and working with more consultants and epidemiologists to improve the quality of health care,” said Sen. Dede Feldman, D-Albuquerque. “But they have a ways to go in figuring out to report the information to the public in a usable manner.”

The state’s evolving program

The soon-to-be state website is an outgrowth of New Mexico’s move toward greater transparency regarding hospital-acquired infections, a problem receiving increasing public scrutiny across the nation.

In 2008, the state started tracking an infection that patients developed during stays at hospital intensive care units (ICUs). Nineteen incidents of central line–associated hospital infections in the ICUs were reported at six New Mexico hospitals from July 1, 2008, to May 31, 2009, according to a 2009 state report. A central line is similar to an IV. The rate of infection was lower than the national rate, according to a report last year. But it wasn’t clear where the incidents took place.

Since the initial pilot study more hospitals have joined the state’s voluntary program, Busemeyer said, with 17 hospitals reporting the number of central-line bloodstream infections patients contracted in ICU wards. Meanwhile, 25 facilities report on how many health care workers are vaccinated for influenza.

And in November participating hospitals will begin reporting two more infections: central-line-associated hospital infections outside of hospital ICUs  and clostridium difficile, a colon infection.

In addition, New Mexico has hired several staff to help run its new infection program, including two epidemiologists, a nurse, a program manager and several contractors, using more than $1 million in federal stimulus dollars, Busemeyer said.

The federal government is doing its part to require disclosure. In January a new federal rule will require 47 hospitals in New Mexico to report central line-associated infections to authorities in Washington. That information will wind up on the U.S. Department of Health and Human Services’s publicly accessible Hospital Compare web site, the state health department said Wednesday.

Hospitals that don’t report the infection data required potentially could lose some federal funding.

“New Mexico hospitals welcome the requirement,” Jeff Dye, president and CEO of the New Mexico Hospital Association, was quoted as saying in a  news release issued by the New Mexico health department Wednesday. ” Many have already built the reporting structure and those that have participated in the state pilot project have outperformed national averages.”

But the state’s decision to rely on voluntary reporting of infections despite a recommendation in a 2009 Healthcare-Associated Infections Advisory Committee report to mandate such disclosure potentially means that hospitals don’t have to notify the state of certain infections if they don’t want to. For example, clostridium difficile, the colon infection that participating hospitals will begin to report voluntarily in November.

Moving toward transparency

The move to tamp down on hospital infections has dovetailed with a national movement for medical facilities to become more transparent about the quality of care they provide patients.

The movement got much of its impetus from a 1999 Institute of Medicine (IOM) report “To Err is Human,” which estimated that up to 98,000 deaths and hundreds of thousands of injuries occur annually in the U.S. because of medical errors and infections.

In 2006, just two conditions caused by hospital-acquired infections in the U.S. (sepsis and pneumonia), were responsible for nearly 50,000 deaths and cost more than $8 billion to treat, according to a February report in the Archives of Internal Medicine.

Hospital-acquired infections have garnered so much public attention the new federal health care reform law addresses the issue.

One of the provisions in the law will require more public reporting of medical errors, including hospital-acquired infections, according to the Consumers Union, which publishes the magazine Consumer Reports.

Beginning in 2014, the U.S. Health and Human Services Department will report, on its Hospital website, each hospital’s record for medical errors and infections involving Medicare patients, the consumers organization found during a review of the new law.

The federal law also attempts to encourage better patient outcomes through incentives and restrictions, the consumers organization says.

Beginning in October 2012 non-rural acute care hospitals that beat federal performance standards for at least five measures, including certain hospital-acquired infections, will receive higher Medicare payments, the organization found in its review of the law. Medicare is a federal health insurance program for individuals over the age of 65 and individuals under 65 with certain disabilities.

Two years later in 2014, the federal government will reduce Medicare payments by one percent for those hospitals with the highest rates of medical harm as measured by “hospital-acquired conditions,” the Consumers Union reports.

Those include certain preventable infections and medical errors, such as serious bedsores, catheter-associated urinary tract infections and certain types of falls and trauma, the organization reports.