Mandate reporting of Ky. health-care related infections

Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA.
Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA.

By Kevin Kavanagh

I often wake up at night scared of having to have another operation on my neck. I have had three, along with two metal implants, and the associated scarring and neuropathy which occur when one tries to get a few extra miles out of an old car.

This is one of the reasons I am so concerned about health-care associated infections, which affect one in 20 hospitalized patients and by many measures appear to be getting worse.

The whole health-care system is at risk, including nursing homes, dialysis centers, critical access hospitals and even ambulatory surgery centers. Acute-care hospitals comprise less than 20 percent of the health-care facilities in Kentucky.

This was one of the reasons why, in 2011, I wrote an op-ed regarding the high infection rates at the University of Kentucky which involved treatment catheters inserted into large blood vessels. This type of infection is one of the few which has rates posted on Medicare's Hospital Compare website.

After the op-ed was published, I received a lot of negative comments and excuses, involving risk adjustment, sick patients and a treatment center of last resort. Others asked how I could negatively comment on an idol of the Big Blue Nation.

As a testament to the commitment of UK to patient safety and the power of public reporting, UK's rate for this deadly infection has dropped over 40 percent.

However, for the state as a whole, the rate of this infection is well above the national average.

Recognizing the dangers of health-care associated infections, Rep. Tom Burch, D-Louisville, is sponsoring House Bill 460 to create a comprehensive statewide reporting system which would involve all types of health-care facilities and many types of dangerous bacteria.

The information would also be available to the public.

Health-care industry witnesses appeared to have presented incorrect information when they testified against the bill March 6 before the House Health and Welfare committee.

They were asked if any of the various types of facilities in Kentucky were exempt from reporting. The answer was no, that all facilities had to report through the Centers for Disease Control's national reporting system.

However, critical-access hospitals and ambulatory-surgery centers are not required to report infection to the CDC.

Nursing homes also do not have to report through the CDC's system. They do separately report urinary tract infections to the Centers for Medicare and Medicaid Services, but there is no data on the deadly Staph infection, MRSA, or the deadly G.I. infection, C. Diff, which can run rampant in some nursing homes.

Industry representatives were also asked if a patient who was going to have hip surgery could find information on infection rates on Hospital Compare. The answers appeared to indicate that such information was available.

Because of my neck implants and possible future surgery to have more hardware inserted, I constantly scour the Internet for this information.

In Kentucky, because of a lack of an adequate state reporting system, this information is woefully inadequate.

For acute-care hospitals, only, bloodstream MRSA infections (a relatively rare event), colon surgeries, abdominal hysterectomies, urinary tract infections and central-line infection data can be found. Little use for patients needing hip surgery.

In the past, CMS has posted on the Hospital Compare website information regarding hospital-acquired conditions, and was slated in the future to have information on neck and spine surgery.

However, this information is now gone from Hospital Compare. I can only assume it, too, has fallen to the legions of health-industry lobbyists.

These are clear examples of why our health-care system has been ineffective in addressing health-care associated infections. The people in whom we place our trust appear to have thrown us under the bus in a cloud of secrecy.

The lack of a comprehensive, transparent statewide reporting system places us all at risk and may set us back some 200 years to a time when devastating epidemics of untreatable bacteria ravaged civilization.

Before obtaining health care, all of us need to ask facilities what their rate of infections are. As aptly stated by President Ronald Reagan, "Trust but verify."