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ASHRM takes message to the Hill
WASHINGTON – ASHRM leadership took the society’s messages on patient safety and medical liability reform legislation to Congress on March 10 and 12.
“On behalf of ASHRM members, we were able to stress that health care providers should have the freedom to practice in an accountable manner so that patients have access to quality patient care,” President Jane McCaffrey said in summing up the tour. “We also pointed out that patient safety is compromised when resources are unfairly diverted to support liability coverage at the expense of patient care.”
Ms. McCaffrey, President-Elect Jeff Driver, Past-President Monica Berry, and Executive Director Liz Summy called on Senate leadership to consider the risk management perspective when they introduce legislation for patient safety and medical liability reform.
ASHRM leaders met with key staff members of senators with influence over these bills, including Senate Majority Leader Bill Frist (R-TN), as well as Sens. James Jeffords (I-NH), Lindsey Graham (R-SC), Peter Fitzgerald (R-IL) and Edward Kennedy (D-MA).
The meetings provided a great opportunity to answer questions and lay out principles for patient safety legislation and medical liability reform legislation:
ASHRM guidance for patient safety legislation
- Create a voluntary reporting system for examining national trends in medical error occurrence and developing targeted procedures and tools to prevent the recurrence of those errors and patient injury
- Provide strong federal legal protection of the data submitted by providers to ensure and encourage accurate reporting
- Authorize an entity, such as the Agency for Healthcare Research and Quality (AHRQ), to certify patient safety organizations (PSOs) and collect non-identifiable patient safety data in order to help standardize the flow of patient safety data to and from providers, practitioners, researchers, and consumers.
ASHRM is committed to working with Congress to strengthen patient safety legislation and encourages Congress to:
- Maintain and strengthen confidentiality and legal protections by:
- Distinguishing patient safety data from contents of the medical record
- Including incident reports within the definition of patient safety data
- Identifying the “qualified entities.”
- Define a “reporter” by designating a particular person(s) responsible for reporting the data, such as the risk manager or other related patient safety position within the organization by:
- Organizing the reporting responsibilities around internal hospital processes
- Allowing “reporters” to report first to their organization rather than directly to a PSO. Doing so would further enhance the provider’s ability to learn from their experience and turn that learning into patient safety improvements without delay.
- Stipulate that the PSO has no regulatory or enforcement authority by:
- Eliminating Civil Monetary Penalties (CMPs), which are unjustly punitive and counter to a health care organization’s efforts to create a culture of safety that encourages reporting to improve safety.
ASHRM guidance for medical professional liability reform legislation
- Allow well-founded and balanced recovery for damages
- Include affordable liability coverage as a key component of the health care infrastructure
- Restore liability resources that have been diverted from patient safety
- Recognize improvements in patient safety and quality of care are integral to tort reform through:
- Disclosing unanticipated medical events
- Sharing information
- Understanding why systems fail.
ASHRM is committed to working with Congress to strengthen medical liability reform legislation and encourages Congress to:
· Provide providers with freedom to practice in an accountable manner so patients have access to quality care
- Support modern civil liability reform by creating economic efficiencies through:
- Joint and several liability
- Limitations of attorney’s fees
- Use of alternative dispute resolutions
- Reduction of statute of limitations and statute of recovery.
For updates on the status of patient safety and medical liability reform legislation, ASHRM members can access bill language at http://thomas.loc.gov/. The ASHRM Advocacy and Legislative Affairs Committee is tracking legislative developments and will continue to provide updates to the membership via e-Alerts and the ASHRM Web site.
Early notice: Plans take shape for annual events
It’s time to start making plans for the biggest events in ASHRM’s annual lineup of education offerings: National Health Care Risk Management Week and the Annual Conference & Exhibition.
Each mid-June, ASHRM sponsors National Health Care Risk Management Week to bring wider appreciation to the profession. This year, the dates are June 16-20 and the theme is “Safe and Trusted Health Care: We’re All In It Together.” An expanded 2-hour educational audio conference/Webcast based on the theme will be held June 18.
Meanwhile, members are encouraged to participate now by:
Reviewing the online catalog of new commemorative logo items at www.ashrm.org. Useful items such as pens, Post-It notepads, padfolios and zipper tote bags will be appreciated by coworkers as giveaways during promotional efforts at your facility.
Arranging for speakers of interest such as a state senator or representative to speak to medical staff or board about risk management issues.
Soliciting ideas from staff who contribute to patient safety and other risk management strategies. Promote those ideas and strategies during National Health Care Risk Management Week (and reward great ideas with logo items).
Getting budget approval for the June 18 audio conference/Webcast on patient safety. Cost per site will be $199 for members, $249 for non-members. Registration will open in April.
ASHRM’s Annual Conference & Exhibition is the profession’s No. 1 networking and education program, and this year’s theme – “Grand Ole Opportunity” – emphasizes that fact.
The Gaylord Opryland Resort and Convention Center in Nashville, TN, will play host to the 23rd annual event Nov. 2-5. Whatever the weather, Gaylord Opryland boasts a comfortable climate – glass atriums encompass acres of indoor tropical gardens, a winding river, and sparkling waterfalls. The hotel is located within walking distance of a professional golf course, the legendary Grand Ole Opry and shopping.
Traditional rooms will be available to ASHRM attendees for $170 single/$190 double; Garden Terrace rooms will be available for $220 single/$240 double. The ASHRM room block will open on May 19.
As always, ASHRM’s 23rd Annual Conference & Exhibition will provide grand opportunities to advance the role of the health care risk management professional as an innovative leader in promoting safe and trusted health care.
Concurrent sessions will be organized into six educational tracks: Claims & Litigation, Enterprise Risk Management, Legal & Regulatory, Risk Financing, Patient Safety, and Special Topics. Also, each concurrent session will be ranked by educational level: “Essentials” or “Applications/Advanced.” Essentials sessions are designed for the beginning risk management professional or someone who wants a refresher course on a certain topic. The Applications/Advanced sessions are designed for the more experienced risk management professional who desires in-depth analysis and study.
Details are available in the conference brochure due out in May.
HIPAA 2003: The year of implementation
Although the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was best known for protecting consumers’ health insurance coverage after job changes, recent attention has focused on another aspect of the law. HIPAA also provides protection for the privacy and security of patients’ health information and mandates significant modifications to the way in which providers handle the submission of claims and other related transactions, with particular attention to electronic communications.
Compliance with these new standards is legislatively mandated and is the focus of this article.
For a background on the HIPAA rules mentioned below, see the March-April 2002 issue of the Forum (which is available online in the Members Only area of www.ashrm.org). Here’s an update to the rules:
Transactions and code sets
The final rule on Transactions and Code Sets was published in the Federal Register on Aug. 17, 2000, for implementation Oct. 16, 2002 (the extended deadline of Oct. 16, 2003, applies for hospitals that submitted a summary compliance plan to the Department of Health and Human Services, HHS, by Oct. 15, 2002). Changes were published Feb. 20, 2003; there must be compliance with these as of Oct. 16, 2003, as well. A copy of the final rule can be obtained at www.cms.hhs.gov/regulations/hipaa/cms0003-5/0003ofr2-10.pdf.
Responsibility for enforcement of the transactions and code set standards and related rules has been given to an office within HHS’s Centers for Medicare and Medicaid Services (CMS) – Office of HIPAA Standards.
Privacy
Under the mandate of HIPAA, when Congress failed to enact medical privacy legislation by August 1999, the responsibility to develop regulations to protect the privacy and confidentiality of all individually identifiable health information passed to the HHS Secretary. The final rule on privacy was published on Dec. 28, 2000, for implementation by April 14, 2003. A copy of the final rule may be obtained at http://aspe.os.dhhs.gov/admnsimp.
The HHS Office of Civil Rights (OCR) will primarily rely on “voluntary compliance” to monitor whether health care providers are abiding by the HIPAA regulations on medical records privacy. During the implementation phase of the privacy regulations, HHS is expected to offer education and technical assistance to help hospitals and other covered entities comply with the rule’s requirements.
Security
The security rule becomes effective on April 20, 2003, and hospitals have two years from the effective date – until April 20, 2005 – to comply. To view the final rule, go to www.access.gpo.gov/su_docs/fedreg/a030220c.html (under HHS).
Areas for risk management monitoring
An overall HIPAA compliance strategy must be enterprise-wide and focus on process improvements and behavior change. Key strategic decisions need to be made with regard to organization, operations, monitoring and evaluation, and documentation of compliance efforts.
Here is a checklist that risk managers can use for awareness about relevant risk management issues and concerns related to regulatory compliance:
-Establish a cross-functional team to monitor all areas of compliance as a critical strategy toward minimizing opportunities for liability exposures. Team members may include:
- risk managers
- legal counsel
- finance officers
- information systems directors
- medical records staff
- medical and clinical staff
- admissions staff
- privacy officers
- compliance officers
- other organizational leaders critical to minimizing compliance liability exposures.
-Identify and become familiar with the wide scope of issues of risk management interest including, but not limited to:
- compliance with information systems regulations, implementation of solutions, and compatibility with regulatory requirements
- law enforcement and media access to patient information
- peer review protections
- confidentiality of behavioral health information
- HIPAA’s impact on telemedicine activities
- disclosure of patient information in natural disasters or terrorist incidents
-Perform ongoing risk assessments to monitor any areas of concern.
-Become familiar with state laws and statutes that may preempt HIPAA if they are more stringent with respect to privacy and confidentiality of patient information.
-Ensure that information about organizational HIPAA strategic initiatives is incorporated into board reports.
-Build a library of resources (publications, seminars, Web sites, professional network) to facilitate HIPAA compliance.
-Plan educational programs to describe HIPAA requirements for all staff, volunteers, et al.
-Modify contractual agreements with outside vendors, third-party payors and others to make sure that they address HIPAA compliance.
-Monitor insurance policies for compliance with HIPAA.
-Update policies, procedures and forms involving protection of confidentiality of patient information.
-Review business associate agreements with accrediting bodies.
-Ensure that physician responsibilities for protecting health information confidentiality is incorporated into medical staff bylaws or rules and regulations.
-Ensure that employee responsibilities for protecting health information confidentiality is incorporated into the employee handbook. There must be sanctions for violations of rules.
Additional HIPAA resources
American Hospital Association, www.aha.org (click on the “HIPAA” icon under “Key Issues”).
American Health Information Management Association, www.ahima.org
Centers for Medicare & Medicaid Services, www.cms.gov
Department of Health and Human Services, www.dhhs.gov
Transactions and Code Sets Frequently Asked Questions: http://aspe.hhs.gov/admnsimp/bannertx.htm
HIPAAProf training program, www.hipaaprof.com/aha
NEW CPHRMS
The Certified Professional in Healthcare Risk Management designation provides a credential based on a solid assessment that verifies a broad-based knowledge of risk management. Certification elevates professionals to elite status among peers in an increasingly competitive marketplace.
Congratulations to recent CPHRM achievers:
Thomas G. Bartlett III, Tyrone, PA
Donna L. Cool, Goose Creek, SC
Sherrie Lynn Dulworth, Mt. Kisco, NY
Michael S. Klueh, Evansville, IN
Mary A. Kowalczyk, Westminster, MD
Leslie Shaw Norman, Prairieville, LA
Denise Ann Pietri, Sebring, FL
Marsha Marie Studer, St. Paul, MN
The Certified Professional in Healthcare Risk Management designation is offered through the American Hospital Association Certification Center.
To learn more, visit www.ashrm.org .
500th CPHRM candidate is certified
Marsha Marie Studer on Feb. 28 became the 500th individual to be designated by the American Hospital Association’s Certification Center as a Certified Professional in Healthcare Risk Management (CPHRM).
“I believe it should be a threshold that all risk managers meet in order to assure individuals who work with risk managers that they have a good knowledge base,” said Ms. Studer, vice president of risk management at Allina Health System in Minneapolis. “I have been practicing as a risk manager for a number of years, and I felt that I needed to support my profession’s certification program. Now I’m asking all my risk managers to become certified as well.”
Since its inception in 2000, the CPHRM designation has distinguished health care risk managers among their peers by formally recognizing those individuals who meet the eligibility criteria and pass a nationally administered examination. For details on certification, contact Marie Lawrence of the AHA certification center at (312) 422-3713 or mlawrence@aha.org .
Barton Modules head to Chicago
The next Barton Modules sessions are coming right up – June 2-6 in Chicago.
Earlybird registration rates will be offered through May 2: $575 for members, $675 for non-members. After May 2 and until the close of pre-registration, the fees are $625 for members, $725 for non-members.
Lively, engaging sessions led by ASHRM experts will cover practical information that health care risk management professionals need to know today.
The Essentials module is aimed at risk managers with up to 2 years of experience. Among topics on the agenda are:
* risk management program development
* claims management
* trends & emerging opportunities in risk management.
The Applications module is designed for risk managers with less than 5 years of experience. Agenda topics include:
* EMTALA and HIPAA developments
* Accreditation preparation
* Homeland Security/Patriot Act
* Informed consent
. . . and much more.
Also, those who have already completed two or three modules can complete
their certificate requirements by participating in the Advanced Forum module, an interactive session focusing on critical thinking and analysis of hot issues in risk management.
For details on the program (including CEUs) and to register online, please visit www.ashrm.org or use ASHRM’s Fax on Demand service, (800) 764-3294 and request number 432204.
Non-members can save an additional $100 in modules fees by joining ASHRM today. Please visit the Web site for membership details or call (312) 422-3980.
a name="#audio">Audio conferences now on CD
Beginning with its April 29 audio conference “Patient safety strategies for perioperative services,” ASHRM will offer CD recordings of its education programs.
The audio CDs are formatted for use in car, home, computer or portable CD players. The sound quality is digitally maximized and track markers are inserted at 5-minute intervals for listener convenience.
Prices for recordings, whether CD or audiotape, are the same as the site fees plus $5.50 per tape or CD for shipping and handling.
“Patient safety strategies for perioperative services” will address common errors, point out underlying causes, and provide prevention strategies for facing patient safety challenges during the time of hospitalization for surgery to discharge.
For details on the audio conference and to register, consult visit www.ashrm.org.
New tool can help show value of RM
One of the more challenging questions that risk management professionals face is “What is the value of risk management?”
To help answer that question, ASHRM has developed the new “Self-Assessment Tool for Risk Management Programs & Functions” (2nd Edition). Risk management professionals will find these evaluation templates invaluable for:
- Organizing a risk management program, functions and activities
- Developing tailored program structure, process, and outcome measures
- Evaluating the completeness and effectiveness of risk management programs
- Gathering data and demonstrating value to management
- Justifying the need for additional resources
- Planning actions for program enhancements.
The tool is available for purchase in CD format from the AHA Online Store, www.ahaonlinestore.com or (800) AHA-2626. Orders will be filled starting May 5. Ask for item # 178933. The price is $99 for members, $149 for non-members.
