There are a lot of things in healthcare that defy common sense. For example, healthcare is one of the few areas where new technology often adds to cost, and where the proverbial pound of cure is rewarded far more than the ounce of prevention.
So, it shouldn't have been a complete surprise to learn that—22 years after Congress passed legislation that would allow for a Healthcare Integrity and Protection Data Bank to document disciplinary problems among more healthcare professionals—hospitals and nursing homes still can't access the data.
According to the consumer group Public Citizen, the legislation that was supposed to allow access to the disciplinary data—Section 1921 of the Social Security Act—was enacted 1987, but HHS has never implemented Section 1921.
Until that happens, more than 5,000 non-federal hospitals and 700 nursing homes cannot access the data bank. In fact, under the law now, if a non-federal hospital or nursing home tried to access the data they'd run afoul of HIPAA laws.
A little perspective is needed here. In 1987, Ronald Reagan was president, Michael Douglas won an Oscar as Gordon Gekko in Wall Street, and The Simpsons made their first TV appearance on The Tracy Ullman Show.
In a recent letter to HHS Secretary Kathleen Sebelius, Public Citizen urged her to implement Section 1921.
"Many of these workers would not have jobs in the healthcare field if their current employers knew about their checkered pasts," says Sidney Wolfe, MD, director of Public Citizen's Health Research Group. "Keeping these records secret greatly increases the chance that patients will be injured or killed at the hands of their caretakers."
Public Citizen notes that, as of Dec. 31. 2007, the healthcare database listed:
- More than 40,000 nurses sanctioned for health care-related violations, including unsafe practice or substandard care (23,551 reports), misconduct or abuse (10,930 reports), fraud/deception/ misrepresentation (3,437 reports), and improper prescribing/dispensing/administering drugs (7,526 reports).
- More than 49,000 LPNs and nurse aides sanctioned for healthcare related violations such as unsafe practice or substandard care (16,110 reports), misconduct or abuse (12,197 reports), fraud/deception/misrepresentation (4,247 reports), and improper prescribing/dispensing/administering drugs (4,634 reports).
Apparently, Section 1921 got whisker-close to implementation in October 2008, when HHS submitted a final draft to the Office of Management & Budget. However, the paperwork got lost in the presidential transition. As a result, the regulation will have to start anew through departmental clearance, which could delay access to the data bank until 2010 or beyond.
Of course, President Obama should not be singled out for blame on this issue. We can thank in equal parts Presidents Reagan, Bush XLI, Clinton, and Bush XLIII equally for their bipartisan indifference.
However, Obama is the man now and when he ran for the job last year he promised us "Change We Need." May I respectfully suggest he take up Section 1921—with all haste—and address the change we needed 22 years ago.