Hospital infection report lagging

COLUMBIA — South Carolina is among a handful of states requiring public reporting of hospital-acquired infections.

While hospitals are complying with the law and sending infection reports to state officials, making that information public is probably going to take longer than expected.

The Hospital Infections Disclosure Act, which became South Carolina law in May 2006, mandates that hospitals report preventable infections to state health officials and that the first report to the public be made by Feb. 1.

In addition to the looming public deadline, another issue is how useful the data will be once it is released.

"We're at the cutting edge of a lot of problems," said Dr. Jerry Gibson, an epidemiologist with S.C. Department of Health and Environmental Control. "We're in the process of figuring out a lot of these problems. We're one of the first states with this legislation."

Pennsylvania, Missouri and Vermont have reached their goals of publicizing infection rates, and states nationwide are considering similar laws.

About two months from their deadline, the advisory panel tasked with organizing the effort still had questions Nov. 28.

The biggest issue remaining, and the one likely to delay the data's release, is how to validate what hospitals report.

Dixie Roberts, health care infections section director with DHEC, said hospitals across the state are using an Internet-based reporting program from the Centers for Disease Control and Prevention, which is expected to release a standard this month to validate the data hospitals submit.

Tracking patients' prescriptions, lab results and re-admissions might be ways to find out if hospitals are reporting infections properly.

Several committee members suggested delaying the release of information until July to make sure the numbers are vetted.

Sen. Ralph Anderson, D-Greenville, who shepherded the disclosure act through the General Assembly, said he would not support an extension of the release date. If problems arose with validation this month, he would consider a month or two-month extension.

"This is serious. People are dying every day. The public is looking to hear from us," Anderson said.

One observer at the meeting last week was Bill Percival of Greenville, who said he underwent chemotherapy in 2005 for lymphoma and in the process suffered five staph infections.

"They wouldn't tell me what kind of infection I had," he said, but the antibiotic he was prescribed is routinely given to treat hospital-associated methicillin-resistant Staphylococcus aureus, or MRSA, a staph infection resistant to penicillin-type antibiotics.

Percival attended the Hospital Infection Disclosure Act Advisory Committee's monthly meeting to see what epidemiologists, statisticians and doctors are doing to make information public about hospital-acquired infections.

"It's a foot-dragger," Percival said. "If Moses had a committee, we'd still be in Egypt."

Rick Foster, vice president for quality and patient safety with the S.C. Hospital Association, said he wanted to make clear that hospitals are reporting the data as mandated by law and are not responsible for the possible delay.

Hospitals have reported data to the CDC program, to which DHEC has access, since July. Facilities could face fines or loss of their license for not complying.

Another complaint critics weighed was that the types of infections reported are so strictly defined that the rates will be low when compared to national numbers. In other words, when a consumer checks DHEC's Web site to see how many surgical site infections occurred at a given hospital, the number will reflect only a handful of procedures, not all surgical site infections.

Foster said broader reporting will be phased in over four years. The CDC system is designed to be specific in order to mine data. That way, if a hospital has a high rate of infections, the data should be able to specify the surgeons and units to isolate problems.

Several additions to the reporting requirements were announced Nov. 28, expanding the procedures and locations reported. The most notable change, however, was that DHEC made MRSA a reportable infection.

DHEC also will track community-associated MRSA on its own in 2008 and plans to break down infections by county of residence.

John Ruoff, research director for consumer advocacy group South Carolina Fair Share, lobbied for the disclosure act, but he said he will not be dismayed by a delay in releasing the data.

"My concern is putting out unvalidated data," he said. "I don't worry they'll over-report. But those that under-report will get knocked into line by validations."

Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.