During last week’s New Hampshire Hospital Association Annual Meeting we heard a number of excellent speakers tackle such issues as the ACA and the states’ soon-to-be launched “Marketplaces,” as well as the evolving – rather rapidly it appears – “best practice” of physicians and hospitals learning how to apologize early on (i.e. immediately after) the occurrence of a bad incident that has befallen a patient. With regard to the former, the drama that is the ACA and its launch is well-covered, while with regard to the latter the University of Chicago Medical Center has adopted a well-organized and structured methodology to address mistakes as soon as they occur with patients and their families. I think this will be an evolving practice that ultimately will be “THE” standard practice.
But another topic also came to light at the NHHA Annual Meeting. The subject – drug diversion and, in particular, drug diversion by medical technicians and other employees of health care providers.
While the Exeter Hospital situation could have happened anywhere, that it happened in New Hampshire through the sad facts it did may result ultimately in attention at the national level in the hallowed halls of CMS as well as in the NH legislature. Our state’s Commissioner of Health and Human Services recently sent a letter to CMS requesting that at the federal level a national registry/system to deal with “drug diverters” be created. Here in NH, and introduced in the last session by, among others, Representative Sherman, a legislator and a GI physician, HB 658-FN set out to require all persons employed as medical technicians to register with the state prior to commencing employment in New Hampshire. Sounds logical and simple enough – the medical technician at issue in the Exeter matter had spun a dangerous web as he travelled from state to state in search of employment and, crucially, pharmaceuticals to feed his habit. The bill has been in a study committee over the summer and should see the light of day soon. How to define “medical technician” is an issue, and one that will be refined and clarified during rule-making at the NH Department of Health and Human Services. What is clear is that health care providers will need to insure that, indeed, registration has taken place.
On the same front, HB 597-FN attacks the problem through mandatory drug testing of certain health care workers. It, too, has undergone study over the summer. The proposed bill calls for “suspension of license” and other remedies contained within the NH licensing statue (RSA 151) if it is not followed. Again, the rule-making process is certain to be key in defining exactly who and what are covered.