- • No Mandatory Physician Participation
MN Statute §144.7065(1) states:
Each facility shall report to the commissioner the occurrence of any of the adverse health care events described in subdivisions 2 to 7 as soon as is reasonably and practically possible, but no later than 15 working days after discovery of the event. The report shall be filed in a format specified by the commissioner and shall identify the facility but shall not include any identifying information for any of the health care professionals, facility employees, or patients involved. The commissioner may consult with experts and organizations familiar with patient safety when developing the format for reporting and in further defining events in order to be consistent with industry standards.
Physicians have no requirement by law to participate in the reporting of adverse health care events, all of which are limited by law to hospitals and outpatient surgical centers.
- • Professional Re-licensure/Review Boards Must report suspected adverse events
In May 2004, 2004 Chapter 186 modified the reporting system for the Adverse Health Care Events Reporting Act by mandating that “health licensing boards that regulate physicians, physician assistants, nurses, pharmacists, and podiatrists are required to report to MDH events that come to their attention that may qualify as adverse health care events.” [MN Statute §144.7068] Moreover, the law states that “The report shall not include any identifying information for any of the health care professionals, facility employees, or patients involved.”
- • No requirement for physicians / health-licensee self-reporting of adverse events
Only adverse event reporting occurring within hospitals or outpatient surgical centers is addressed. Physician self-reporting and reporting by physicians of adverse events occurring within or outside of hospitals or outpatient surgical centers is not addressed.
The exclusion of physician identification in adverse events reports represents a philosophy incorporated into the law, as noted in §144.7067(a) of the Adverse Health Care Event Act.
- (a) The commissioner shall establish an adverse health event reporting system designed to facilitate quality improvement in the health care system. “The reporting system shall not be designed to punish errors by health care practitioners or health care facility employees.”
As stated by Marie Dotseth, MHA, Senior Policy Advisor for Patient Safety, Minnesota Department of Health The Reporting of Adverse Events in Health Care: Minnesota's Law – August 2004 [PDF], this effort represents Minnesota's effort to balance “quality improvement and accountability for public health and safety.”
However, as discussed in 8. Features of Program for Reporting, there appears to be transparency of information that necessarily must include health provider identifiers in adverse events review and peer review efforts, if those efforts are addressed by the same review organization. Insofar as the legislation does not require facilities to segregate review organizations that manage adverse event reporting and peer review, it will be impossible to remove physician and health provider identifiers from local facility deliberations. Furthermore, since the Commissioner of Health has access to all records per §145.54(5), the Commissioner also has access to physician and healthcare provider identifiers. Whereas the MDH indicated in 2004 “ . . that the Adverse Event activity will be distinct from the MDH facility regulation with distinct Adverse Event staff and processes,” efforts to accomplish the same segregation of regulatory and Adverse Event activity at local facilities for physicians and licensed health professions is less likely.