NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7465
SPONSOR: Gottfried TITLE OF BILL: An act to amend the public health law, in relation to
hospital sepsis data
PURPOSE OF THE BILL:
This bill would provide the Department of Health (Department) and all
hospitals the time necessary to assure that certain hospital quality
measures relating to sepsis are accurate, valid and reliable, and appro-
priately reflect care provided by individual hospitals before public
release of hospital specific data.
SUMMARY OF PROVISIONS:
Section 1 of the bill would add new Public Health Law (PHL) § 2805-m (4)
to deem the initial-period of collection of hospital sepsis data by the
Department as a "pilot phase not exceed two years. During the pilot, the
Department would: (1) ensure that all sepsis data included in public
databases and reports is encrypted to prevent hospital identification;
(2) provide each hospital with access only to the data submitted by that
particular hospital; (3) consult with appropriate stakeholders regarding
the public release of such data concerning hospital performance; and (4)
provide regular reports to hospitals regarding the accuracy of the data
submitted and give guidance for improving the accuracy of such data.
Section 1 of the bill would also provide that after the pilot phase, the
sepsis data submitted by hospitals and compiled in a database by the
Department would include hospital identifiers. The reports made publicly
available from such data would also include hospital identifiers. The
Department would also develop and post the data on the Department's web
site.
Section 2 of this bill provides that the bill would take effect imme-
diately.
EXISTING LAW:
PHL § 2805-m contains the confidentiality provisions governing informa-
tion collected and maintained for purposes of medical, dental and podia-
tric malpractice prevention programs, investigations prior to granting
or renewing privileges, and adverse event reporting via the New York
Patient Occurrence and Tracking System.
10 NYCRR § 405.4(a)(7) requires hospitals to collect, use, and report
quality measures related to the recognition and treatment of severe
sepsis for purposes of internal quality improvement and for reporting to
the Department.
PRIOR LEGISLATIVE HISTORY:
2013-2014: S.6979 passed the Senate.
STATEMENT IN SUPPORT:
The data collection and reporting requirements governing sepsis measures
adopted in 2013 are novel both in New York State and throughout the
nation. As such, the process for evaluating the data collected to assure
completeness and accuracy, as well as the modeling necessary to develop
fair and accurate risk-adjusted measures of mortality attributable to
sepsis, are also novel and untested. The data collected for purposes of
evaluating adherence to protocols for the prevention and treatment of
severe sepsis and septic shock, as well as data collected for the
purpose of establishing risk adjusted mortality rates related to severe
sepsis and septic shock, must be kept confidential until such time as it
is determined that the data collected are complete and accurate and the
calculations used to develop risk adjust mortality rates have been eval-
uated and tested and found to be accurate.
While it is possible for organizations to develop and publish mortality
rates from sepsis by hospital using existing datasets now readily avail-
able through Health Data NY, the results are likely to be misleading
since they would not accurately reflect important differences between
patients treated at different hospitals. In addition, the data as
currently available does not: (1) adequately adjust for the mix of
patients with severe underlying conditions that dramatically increase
the risk of death from sepsis, such as cancer and AIDS; (2) reliably
adjust for sepsis severity; or (3) reflect patients who are not eligible
for treatment due to advance directives. At the end of the proposed
pilot phase of data collection, the clinical data collected and analyzed
from hospitals would take those factors into consideration when calcu-
lating rates and comparing one hospital to another.
Accordingly, premature release of this data before thorough and careful
analysis may improperly damage hospitals and mislead consumers. This
legislation would allow for a pilot phase, lasting no more than two
years, to complete data collection and develop appropriate analytics to
ensure that the information ultimately made public is accurate and mean-
ingful. The Department would publish this data after validation.
BUDGET IMPLICATIONS:
This bill is not anticipated to have a fiscal impact on the State.
EFFECTIVE DATE:
This bill would take effect immediately.
