Changing health care

Patients’ views could help with evolving practices

With a greatly changing health-care landscape beginning in 2014, which will mean more choices in health-care insurance, require more businesses to either cover their employees or contribute to their premiums, and cover tens of millions of Americans who are not covered now, it is only logical that more should be known about health-care effectiveness.

Part of that is when patients believe that something went wrong with their own care.

Health-care providers, including doctors, have plenty of measurable criteria to determine when all is not well in specific cases of patient care. Their experiences, and a wide range of extraordinary medical equipment that is constantly being improved, make that possible.

But patients can sometimes bring their perspectives, ones that could fill gaps or enrich – or contradict – those viewpoints of the professionals about what did or did not occur. According to a story in Sunday’s New York Times, in the making is a national reporting format for patients who believe their treatment included mistakes by health-care providers.

Some of the examples suggested in the story are an incorrect diagnosis, the wrong test or medicine dosage, or unsanitary conditions. Patients would be asked to describe the mistake and comment on why they thought it had happened.

Participation in the “consumer reporting system for patient safety,” as it is referred to, would be voluntary. Completed reporting forms would be analyzed by private corporations who do such work for the public and private sectors.

The draft reporting form is being prepared by the White House, and after being vetted by a variety of medical organizations is projected to be operational in May of the coming year.

The New York Times reports that several groups, including consumer and medical associations, are supportive of the concept and what is known so far of the details. The American Medical Association, a particularly influential group, is still studying the plan.

Advocates of the possible new reporting believe it will produce data that will lead to fewer mistakes in health-care delivery, and thus reduce costs.

Reporting what has gone wrong is not new, as hospitals have to do that now. But, for patients, there has been no relatively easy and consistent way to claim perceived shortcomings in their care.

In this time of the desire for smaller government, and lower deficits, it is proper to ask whether this planned reporting is necessary and whether it can be done closer to home, such as at the state level. Our initial reaction is that giving patients a clear method to report what they believe was done incorrectly is part of taking responsibility for ones own medical condition and health-care decisions, and that expecting 50 states to shape and administer effective reporting plans is unrealistic.

Given the concern about the coming major changes in health-care delivery, there is certain to be debate about the need for more reporting, and especially for reports that are destined for Washington, D.C. But a good case can be made for hearing from patients for whom health-care delivery was less than perfect, and for the improvements that could result for the patients who come later.