View From The Hill: What’s Next for Patient Safety Policy?


November / December 2006

View From The Hill

What’s Next for Patient Safety Policy?

As the 109th Congress slowly draws to a close, there’s no doubt that enormous opportunities still exist for transforming healthcare with health information technology (HIT), regardless of partisan issues and politics. Democrats and Republicans alike have introduced 62 separate pieces of legislation to address HIT as well as healthcare quality and patient safety-related issues. To date, only one bill has been passed by Congress and signed into law by the president that focuses on patient safety: the Patient Safety and Quality Improvement Act of 2005 (S. 544). Only one bill in 2 years!

It is highly unlikely that any legislation, other than the nine remaining appropriations bills, will be considered during the lame-duck session that runs from Nov. 13 through mid-December. Funding for the president’s health technology initiatives is in trouble, too. The president requested $169 million for HIT projects in the Fiscal Year (FY) 2007 budget. The Senate has reduced this funding by $52.6 million, which is an increase of just $2.0 million over FY 2006 funding levels, and the House has reduced this funding by $17.9 million, an increase of $36.7 million over FY 2006. Unfortunately, the current Continuing Resolution that is funding the Department of Health and Human Services (HHS) has capped funding at the FY 2006 level of effort until the HHS appropriations bill is finalized.

Therefore, November and December are the perfect time for all of us to prepare for the upcoming 110th Congress and strategize regarding the passage of important healthcare quality, patient safety, and HIT legislation. Some of the players may change after the November elections; the issues, however, will remain the same. HIT can transform healthcare quality and improve patient safety with appropriate leadership and funding.

Similarly, as the second term of President Bush’s administration will come to an end in less than 2 years, executive and federal government officials are beginning to leave Washington. To date, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services are currently led by acting officials, Rob Kolodner, MD, and Leslie Norwalk, respectively. Norwalk served on the senior leadership team at CMS for the past 5 years, most recently as deputy administrator.

In Washington, change is inevitable, and all of us must anticipate and plan for it. I believe that HIT has received more attention in the 109th Congress than at anytime since the passage of HIPAA in 1996. Recent reports on HIT and healthcare quality in general are a direct indication of how important these issues have become to all levels of government, elected officials, employers, and the general public.

For example, Health Information Technology in the United States: The Information Base for Progress, a joint project by the ONC and the Robert Wood Johnson Foundation (2006), reports that fewer than 1 in 10 physicians are using what experts define as a “fully operational” system that collects patient information, displays test results, allows providers to enter medical orders and prescriptions, and helps doctors make treatment decisions. The report’s research team also estimates that about 5% of America’s 6,000 hospitals have adopted computerized physician order entry systems, a component of electronic health records to help reduce medical errors and ease care delivery.

In October, the Commonwealth Fund and the Alliance for Health Reform sponsored a Capitol Hill briefing on the Fund’s report, Measuring Up: A Comprehensive Scorecard for America’s Health System. The scorecard compares national averages for the United States to national and international benchmarks for 37 indicators. The United States received a composite score of 66 out of 100. On one quality measure, mortality, the United States ranked 14th out of 19 countries.

The reports are piling up, but when are we going to hear from the people on the frontline? Elected officials still need to hear from those with real stories about the needs to improve patient safety and quality healthcare. No one can educate and inform members of Congress and their staff about the real barriers to improving our healthcare system better than healthcare employees and patients. Industry insiders can brief Congress until we are blue in the face, but we need people who are on the frontlines to bring their stories to Washington. Invite members of Congress and other elected officials to your workplace or home, sponsor town hall meetings, attend candidate forums, and email, call, or write your elected officials. Every major change in public policy has come from the grassroots — people who are on the frontlines of the issue day in and day out.

As we look ahead to the 110th Congress, which will take office in January 2007, it appears that there are three critical health issues that are likely to be addressed: Medicare funding for physicians, personal health records, and privacy. Patient safety and quality healthcare will continue to be at the forefront of our elected officials’ agenda and our challenge is to get this interest turned into meaningful public policy. I will continue to track these and other initiatives in 2007 to keep you posted on our progress.

Dave Roberts is vice president of government relations for the Healthcare Information and Management Systems Society (HIMSS) and chief executive of HIMSS’ Alexandria, VA., Office of Advocacy & Public Policy. Formerly a professional staff member for both the U.S. House Appropriations Committee and the U.S. Senate Health Subcommittee on the Handicapped and a civilian financial analyst for the U.S. Air Force, Roberts now resides with his family in Solana Beach, CA., where he is an elected member of the City Council. He is a member of the Editorial Advisory Board for Patient Safety and Quality Healthcare and may be contacted at


Robert Wood Johnson Foundation. (2006). Health information technology in the United States: The information base for progress. Available at

Commonwealth Fund. (2006, September). Measuring up: A comprehensive scorecard for America’s health system. Available at