Never-Events Follow Up

Last January I posted a piece on ‘Never Events’ . In it, I reflected on punitive action versus supportive action. I am therefore very pleased to read in today’s AIS Health Business Daily that the Blues Plans have stepped up to do just that – support better outcomes – by helping hospitals reduce hospital-acquired infections (HAIs) through the use of electronic tools and incentive programs. The plans include Horizon Blue Cross Blue Shield of New Jersey, Blue Shield of California and Excellus Blue Cross and Blue Shield of New York.

The primary tool used is something called the MedMined electronic infection-monitoring system, and is being offered through Cardinal Health, Inc. (a medical and surgical supplies company). That system supplies an electronic tool that monitors all patients in the hospital for infections as well as an on-site trained infection-control specialist. The tool also is tied to the hospital’s financial system, “so you can see how much a patient without an infection costs, compared to what a patient with an infection costs [for the same procedure],” explains Cardinal Health spokesperson Troy Kirkpatrick.

In addition to Cardinal offering grants to hospitals for adopting patient safety products, the Blues health plans will share the costs of the system for the first few years. According to the AIS story, a health plan could cover 60% of system costs in the first year and 40% in the second year, with the hospital paying for the remaining expenses. By the third year, the hospital would pay all system costs, with savings from reducing hospital acqured infections (HAIs) offsetting that expense.

Apparently, the MedMined tools helped reduce overall HAIs by 3.2% at pilot hospitals in 2007, according to an issue brief from the Blue Shield of California Foundation. That organization has already spent $5 million on the initiative and is working with California’s Healthcare-Associated Infection Prevention Initiative (CHAIPI) to reduce HAIs through MedMined and also through a “learning collaborative” effort among participating hospitals. “Among CHAIPI hospitals, reductions in HAIs resulted in 4,641 fewer hospital days and $2,163,437 in bottom-line savings.…In all, the initial investment in CHAIPI has generated a minimum five-fold return in costs avoided, for a total of more than $9 million” over a period of 18 months, according to the foundation.

This is a very positive development and illustrates how collaborative efforts, rather than puntive ones, can not only help advance medicine and safety but systematically decrease costs for everyone.

Kudos to the Blues for leading the way on this and for taking a stake in securing better outcomes.