Doctors and other healthcare providers will soon be able to submit confidential data on medical errors and near-errors to newly formed patient safety organizations, which will be analyzed for clues on how to improve safety and quality.

"We really need this kind of national initiative to measure errors, adverse events, do some local improvement and aggregate the data so we can learn from it, and begin to improve the entire system," says Lou Diamond, president of the American College of Medical Quality and vice president and medical director of Connecticut-based Thomson Healthcare.

The PSOs are envisioned as groups with expertise analyzing risks and hazards in patient care, which will routinely gather data from providers and other PSOs, and contribute to a network of patient safety databases. The U.S. Agency for Healthcare Research and Quality will analyze the data for trends, making its findings public through its annual National Healthcare Quality Report. The patient safety data will not contain information about individual providers or patients and the Patient Safety Act limits or forbids the use of protected information in court and other proceedings.

"Nobody's sure who's going to step up to the plate and become a PSO," Diamond says. "Stakeholders that have already begun the work of attempting to measure and improve quality in a given geographical area might end up being the kind of organizations that will step forward." To become a PSO, public and private groups can certify themselves as conforming with the 2005 Patient Safety and Quality Improvement Act; the AHRQ will periodically spot-check its list of groups for compliance. The law prohibits insurers and regulators of healthcare providers from becoming PSOs.

The groups will be funded through provider contracts, private grants or their own finances. "The notion of a PSO forming of various stakeholders, then charging fees for them to participate in this enterprise becomes a little bit of an issue-it may be a big barrier," says Diamond. Another barrier will be dealing with small healthcare provider groups and practices lacking infrastructure for this kind of data exchange. Problems might include soliciting their data, helping them integrate changes in practice and convincing them of their legal protections, Diamond continues. Nevertheless, he is excited that proposed PSO regulations are "on the street."

The 2005 Patient Safety Act created the framework for PSOs, and the AHRQ published proposed rules governing them on Feb.12. However, the rules are not yet final-doctors and other parties can comment on them until Apr. 14. Find more details on rule commentary at www.pso.ahrq.gov.

The Patient Safety Act, and its PSOs, resulted from a groundbreaking 1999 report on medical errors from the Institute of Medicine, To Err is Human: Building a Safer Health System. Citing previous research, the IOM reported that medical errors resulted in the deaths of as many as 98,000 people in the U.S. every year, more than from automobile accidents, breast cancer and AIDS combined.

Deaths resulting from medical errors generally stem from systemic problems, rather than the mistakes of individuals, the IOM said. Examples of these mistakes include illegible writing that results in a drug prescription to which the patient is allergic, or the stocking of undiluted drugs in hospital patient-care units.