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THE WHITE HOUSE

Office of the Press Secretary

For Immediate Release December 7, 1999

     CLINTON-GORE ADMINISTRATION TAKES STRONG NEW STEPS TO IMPROVE
             HEALTH CARE QUALITY AND ENSURE PATIENT SAFETY

                            December 7, 1999

Today, President Clinton will launch a new initiative to prevent medical error at a meeting with the Institute of Medicine (IOM), health care consumers, providers, purchasers, and members of the business and labor communities. He will sign an executive memorandum directing the Federal Quality Interagency Coordination (QuIC) Task Force to report back within 60 days, through the Vice President, with recommendations to improve health care quality through the prevention of medical errors and enhancements in patient safety.

The President will also: announce that each of the more than 300 private health plans participating in the Federal Employee Health Benefits Program will be required to institute quality improvement and patient safety initiatives; instruct Federal agencies administering health plans to evaluate and, where feasible, implement the latest error reduction techniques; direct the Office of Management and Budget, the Domestic Policy Council, and other agencies throughout the government to develop meaningful health care quality and patient safety initiatives for the FY 2001 budget; and announce his signing of the reauthorization of the Agency for Healthcare Research and Quality, ensuring a new, multi-million dollar investment in research programs to improve health care quality.

The President will also praise the American Hospital Association for its landmark announcement of a multi-faceted campaign to prevent unnecessary, harmful, and expensive medication errors in 5,000 member hospitals.

INCONSISTENCIES AND AVOIDABLE ERRORS IN MEDICAL PRACTICE COST LIVES AND UNDERMINE HEALTH. Preventable medical errors and inconsistent medical practices are responsible for tens of thousands of deaths, unnecessary illnesses, and instances of prolonged disability each year. These variations in medical practice also increase national health care spending by billions of dollars annually.

Preventable medical errors. A study released last week by the Institute of Medicine estimates that more than half of the injuries caused by medical management occurring each year are due to preventable medical errors places as many as 98,000 Americans at unnecessary risk. These errors cost as much as $29 billion a year.

Under-utilization of services. Early detection and treatment for illnesses prevents unnecessary complications, higher costs, and early death. For instance, despite the fact that early detection of breast cancer can prevent up to 30 percent of breast cancer deaths annually, 30 percent of women aged 52 to 69 do not receive regular mammograms.

Overuse of services. Unnecessary delivery of health care services increases costs without improving health and puts patients at greater risk. For example, the overuse of antibiotics creates unnecessary health care costs and contributes to the emergence of antibiotic-resistant pathogens, resulting in as much as $7.5 billion in unnecessary expenditures annually.

Variation in services. Wide variations in health care practice continue and cannot be accounted for by differences in the health status of patients, available resources, patient preferences, or clinical uncertainty. For example, hospital discharge rates and lengths of stay in the Northeast were over 40 percent higher than in Western states.

NEW ACTION TO IMPROVE HEALTH CARE QUALITY AND ENSURE PATIENT SAFETY.

Today, President Clinton will:

Issue an Executive Memorandum directing the Quality Interagency Coordination Task Force (QuIC) to develop new strategies to improve health care quality and protect patient safety. Today, President Clinton will sign an executive memorandum directing the QuIC to report back to him, through the Vice President, with recommendations that: identify prevalent threats to patient safety and reduce medical errors that can be prevented through the use of decision support systems, such as automated patient monitoring and reminder systems; evaluate the feasibility and advisability of the recommendations of the Institute of Medicine on patient safety; develop additional strategies, including the use of information technology, to reduce medical errors and ensure patient safety in Federal health care programs; evaluate the extent to which medical errors are caused by misuse of medications and medical devices and consider steps to further strengthen FDA's response to this challenge; and identify opportunities for the Federal government to take specific action to improve patient safety and improve health care quality through collaboration with the private sector, including the newly constituted National Forum for Health Care Quality Measurement and Reporting.

Announce that each of the more than 300 private health plans participating in the Federal Employee Health Benefits Program will be required to institute quality improvement and patient safety initiatives. Today, the President will announce that the Office of Personnel Management, which oversees plans serving 9 million Americans, will include in its annual call letter to be issued next spring a requirement that FEHBP plans use error reduction and other patient safety techniques in order to improve the quality of care in the program. In addition, OPM will supplement this initiative using workplace campaigns to improve mammography and medical screening rates among Federal employees, retirees, and their families. Finally, OPM will initiate new ways to measure and report on the quality of care that plans deliver to enrollees.

Instruct Federal agencies administering health plans to evaluate and, where feasible, implement the latest error reduction techniques. The President will request that the Departments of Health and Human Services, Veterans Affairs, and Defense, and the Office of Personnel Management evaluate and, where feasible, implement the latest error reduction techniques in a manner consistent with the Administration's recently released draft regulations on patient privacy. These agencies administer Medicare, Medicaid, CHIP, the Federal Employees Health Benefits Program, the nationwide network of veterans hospitals and outpatient clinics, and the military health care system, serving over 85 million Americans.

Announce the reauthorization of the Agency for Healthcare Research and Quality, ensuring a multi-million dollar investment in research programs to improve health care quality. President Clinton will announce that he signed legislation yesterday re-authorizing the Agency for Healthcare Research and Quality (AHRQ). To achieve the goals of this legislation, which is the result of the bipartisan efforts of Senators Frist and Kennedy and Congressmen Bliley and Brown, the FY 2000 budget increases the agency's resources by 16 percent over FY 1999 funding levels, for a multi-million dollar investment in health care quality. These new funds will be used for important quality improvement research, including the over-and-under utilization of services, variation in the delivery of services, and efforts to prevent medical errors. In recognition of the critical role that states do and will play in assuring and improving health care quality, AHRQ will hold a nationwide conference this March with senior state health officials to promote best medical practices, to prevent medical errors and improve patient safety, and to better develop a working relationship between the Federal and state governments in this area.

Direct the Office of Management and Budget, the Domestic Policy Council, and other agencies to develop additional health care quality and patient safety initiatives for the FY 2001 budget. The President will direct the Office of Management and Budget, the Domestic Policy Council, and the Office of the Vice President to work with the Department of Health and Human Services and other agencies to develop additional initiatives within the context of the FY 2001 budget that build on our current error prevention, quality improvement, and patient safety initiatives.

Praise the American Hospital Association for launching a new medication safety campaign. The President will praise the American Hospital Association for launching a new partnership with the Institute for Safe Medication Practices to prevent patient medication errors. Today, the AHA will send a list of "best practices" on prevention medication errors to all 5,000 of their member hospitals. In the coming months, they will also begin to: develop a medication safety awareness test that surveys hospitals' medication error prevention systems; track implementation by the hospital and health system field of the practices for reducing and preventing errors; and working with national experts to develop a model medication error reporting process. By taking these actions today, the AHA joins numerous other health care organizations making an important commitment to this area, including the American Medical Association's initiative to establish the National Patient Safety Foundation.

THE CLINTON-GORE ADMINISTRATION'S LONGSTANDING COMMITMENT TO IMPROVING HEALTH CARE QUALITY. Assuring quality through providing patient protections is a longstanding priority for the Clinton-Gore Administration. Over the past two years President Clinton and Vice President Gore have provided critical consumer protections to the 85 million Americans enrolled in Federal health plans and set the stage for the Congress to pass a strong, enforceable, Patients' Bill of Rights. In March of 1998, the President established the Quality Interagency Coordination Task Force, which has been instrumental in promoting advances in health care quality nationwide. The President also asked the Vice President to help launch the National Forum for Health Care Quality Measurement and Reporting, a broad-based, widely representative private advisory body that develops standard quality measurement tools to help all purchasers, providers, and consumers of health care better evaluate and ensure the delivery of quality services. In addition to the work and significant potential of the QuIC and Quality Forum, the Departments of Veterans Affairs and Defense have been leaders in patient safety and quality improvement programs. The Department of Veterans Affairs also spearheaded the development of the National Patient Safety Partnership to address issues related to adverse medical events. Finally, the Health Care Financing Administration has implemented new quality improvement initiatives through its peer review organization efforts, and the Food and Drug Administration is working to implement new reporting systems that allow for a rapid response to medical errors causing patient injury.

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