CQ TODAY ONLINE NEWS
Oct. 28, 2011 – 7:55 p.m.
VA Medical Centers Pressed to Set Standard on Prevention of Infection
By John Reichard, CQ HealthBeat Editor
After decades of horror stories about poor patient care, the Veterans Affairs Department’s health care system has developed a reputation for pioneering efficient, high-quality treatment. More recently, it has made progress in preventing the kinds of hospital infections that kill nearly 100,000 Americans each year.
Lawmakers are pushing the VA to pave the way for the use of new medical devices to help hospitals nationwide prevent infections, which drive health costs up by $34 billion a year. Reps.
The effort will be closely watched by other hospital systems, which increasingly face public scrutiny of their infection rates and soon will face penalties through lower Medicare reimbursement rates if patients get sick from infections in their facilities.
Buerkle, the chairwoman of the Veterans Affairs Health Subcommittee, hosted a congressional roundtable on Oct. 25 to review the latest innovations available to reduce hospital infections. She held the session at the request of
The new devices can be costly, however. And VA health facilities are not necessarily more apt to buy them just because the technology promises to save money from reduced infection rates.
Clean or Be Cleaned
One device, a cylindrical instrument reminiscent of R2-D2 from “Star Wars,” was on display at the roundtable. When in use, the device opens and emits flashing ultraviolet light for five minutes — enough to collapse the DNA of bacteria on nearby surfaces, disarming MRSA and clostridium difficile, said Morris Miller, chairman of Texas-based Xenex, which makes the product. At one medical facility where the device has been used, surgical site infections were halved. Surgeons were “astonished,” Miller said. “These environments that you think are sterile like an operating room? Not even close.”
Some simpler products also were on display, such as small green caps filled with alcohol that attach to medicine ports on IV tubing. The caps are sold by Ivera Medical and intended to reduce bloodstream infections linked to IV use. Nurses are supposed to scrub IV ports but often do not and this leads to costly and dangerous “central line” bloodstream infections.
Rigorous hand washing is the most important practice to prevent infections, according to testimony. But it is tough to track such behavior. HyGreen CEO Craig Davenport described an electronic badge that monitors how often health care workers wash their hands. The badge blinks green when a worker has washed his hands and if he approaches a patient’s bed with unwashed hands, the badge vibrates as a reminder. The devices also collect data that hospital managers can review and use to coach employees. The system reduced infections by 89 percent at Miami Children’s Hospital, Davenport said.
Worth the Price?
Progress in lowering infection rates further at VA medical facilities will hinge on partnering with industry, VA officials said. Cost will be a factor. Xenex’s bacteria-killing device costs $35,000. But Miller said the cost of the device is the same as treating a single serious case of infection. And, he said, his product can prevent multiple infections each year. Still, Donna Dunton, infection control director at Eastern Maine Medical Center, said hospital managers are not easily swayed by the promise of savings. “What our accountants tell us is cost avoidance is a soft number,” she said.
Davenport said selling medical technology to VA facilities is “very difficult.” The Food and Drug Administration did not require his company’s monitoring device to get agency approval before being sold. While that saves the company money, the absence of such approval means there is little supporting data on the device’s efficacy, something VA officials want to have to justify health care purchases.
Still, Buerkle said information available on technological devices that can lower infection rates and improve care is not making its way through the VA system. “They’ve got to communicate, they’ve got to make sure that all their facilities have this information,” she said. “And if then they identify a technology that the evidence shows is worth having, that they present it as a national contract versus just one hospital.”
VA Medical Centers Pressed to Set Standard on Prevention of Infection
With VA officials facing greater pressure to use innovative systems throughout their facilities, the lack of data on the effectiveness of such devices could, however, make it hard to fulfill the pacesetter role.