Legislative Update: Bredesen Signs Bill Amending Health Data Reporting Act
East Tennessee Medical News – October 2009
By Jamie Ballinger-Holden

In February 2009, state Senator Jim Kyle and state Representative David Shepard introduced legislation amending the Health Data Reporting Act of 2002 (T.C.A. § 68-11-211).  On May 28, 2009, Governor Bredesen signed the Bill into law.

Originally passed in 2002, the Health Data Reporting Act was created in response to the Institute of Medicine Report titled “To Err is Human,” which found that at least 44,000 and as many as 98,000 people die in hospitals each year as a result of preventable medical errors.¹  The purpose of the Act was to improve the overall quality of health care in Tennessee through the collection and assimilation of health data, in particular data on “Unusual Events” resulting in death or life-threatening injury to a patient, to develop best practices among health care providers.

Pursuant to the original Act, all facilities licensed by the Board for Licensing Health Care Facilities were required to report “Unusual Events” that occurred at a facility to the Department of Health within seven (7) business days.  “Unusual Events” included, among other things, medication errors, falls, hemorrhages, aspiration in non-intubated patients, blood transfusion reactions, wrong patient/wrong site surgical procedures, unintentionally retained foreign bodies, patient abuse or misappropriation of funds, and patient abductions.  The original Act also required the reporting of “Specific Events” that might result in the disruption of health care services at the facility such as a strike by the staff, external disaster impacting the facility, fires, or the like within seven (7) days of the incident.         

Further, for both “Unusual” and “Specific” events, the facility was required to file a corrective action report with the Department. The Department then 1) approved the corrective action report or 2) disapproved the report and provided the facility with a list of actions that the Department believed were necessary to address reported errors.  Using the data acquired, the Department would then provide an annual report to the Board summarizing the type and number of reported “Unusual Events.”

The amended Act limits the incidents to be reported to the Department to Specific Events and those of abuse, neglect, and misappropriation within seven (7) days, unless the facility is required to report an incident pursuant to federal law. Therefore, a facility is now only required to report clinical incidents meeting the following definitions:

Abuse –the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish; or

Neglect –the failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness; or

Misappropriation of Patient Property – the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident’s belongings or money without the resident’s consent.

The new Act, like the original Act, provides that event reports shall be confidential and not subject to discovery, subpoena, or legal compulsion and are not admissible in any civil or administrative proceeding other than a disciplinary proceeding by the Department or the appropriate regulatory board. Facilities also still face suspension or revocation of their licenses for failure to report.

Other changes to the Act include removal of 1) the requirement that the form for reporting incidents be similar to that used by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), 2) the Department’s duty to develop best practices to assist in improving the delivery of health services, 3) the requirement that the Department establish an event occurrence code to be used in reporting “Unusual Events,” and 4) the requirement that the Department provide the Board an annual aggregate report summarizing the type and number of reported “Unusual Events.”

Importantly, the new Act encourages health care providers to continue/begin voluntary reporting to other organizations such as JCAHO and patient safety organizations (PSOs) for the purpose of shared learning from adverse events, even though many of these events will no longer be reported and assimilated by the State of Tennessee.  This amendment signals a shift in Tennessee’s patient safety strategy as it now encourages facilities in Tennessee to rely on the federal Patient Safety and Quality Improvement Act of 2005 (PSQIA) and its subsequently created PSOs, as well as the JCAHO for the development of patient safety initiatives to improve medical services. 

Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.