81 FR 92816 - Common Formats for Reporting on Health Care Quality and Patient Safety

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality

Federal Register Volume 81, Issue 244 (December 20, 2016)

As authorized by the Secretary of HHS, AHRQ coordinates the development of sets of common definitions and reporting formats (Common Formats) for reporting on health care quality and patient safety. The purpose of this notice is to announce the release of the Common Formats--Community Pharmacy Version 1.0.

[Federal Register Volume 81, Number 244 (Tuesday, December 20, 2016)]
[Notices]
[Pages 92816-92818]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-30604]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Common Formats for Reporting on Health Care Quality and Patient 
Safety

AGENCY: Agency for Healthcare Research and Quality (AHRQ), Department 
of Health and Human Services (HHS).

ACTION: Notice of Availability--New Common Formats.

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SUMMARY: As authorized by the Secretary of HHS, AHRQ coordinates the 
development of sets of common definitions and reporting formats (Common 
Formats) for reporting on health care quality and patient safety. The 
purpose of this notice is to announce the release of the Common 
Formats--Community Pharmacy Version 1.0.

DATES: Ongoing public input.

ADDRESSES: The Common Formats--Community Pharmacy Version 1.0 and the 
remaining Common Formats can be accessed electronically at the 
following HHS Web site: http://www.pso.ahrq.gov/common/.

FOR FURTHER INFORMATION CONTACT: Dr. Barbara Choo, Center for Quality 
Improvement and Patient Safety, AHRQ, 5600 Fishers Lane, Room 06N100B, 
Rockville, MD 20857; Telephone (toll free): (866) 403-3697; Telephone 
(local): (301) 427-1111; TTY (toll free): (866) 438-7231; TTY (local): 
(301) 427-1130; Email: [email protected].

[[Page 92817]]


SUPPLEMENTARY INFORMATION:

Background

    The Patient Safety and Quality Improvement Act of 2005, 42 U.S.C. 
299b-21 to b-26, (Patient Safety Act) and the related Patient Safety 
and Quality Improvement Final Rule, 42 CFR part 3 (Patient Safety 
Rule), published in the Federal Register on November 21, 2008, 73 FR 
70732-70814, provide for the formation of Patient Safety Organizations 
(PSOs), which collect, aggregate, and analyze confidential information 
regarding the quality and safety of health care delivery. The 
collection of patient safety work product allows the aggregation of 
data that help to identify and address underlying causal factors of 
patient safety and quality issues.
    The Patient Safety Act and Patient Safety Rule establish a 
framework by which doctors, hospitals, skilled nursing facilities, and 
other health care providers may assemble information regarding patient 
safety events and quality of care. Information that is assembled and 
developed by providers for reporting to PSOs and the information 
received and analyzed by PSOs--called ``patient safety work product''--
is privileged and confidential. Patient safety work product is used to 
conduct patient safety activities, which may include identifying 
events, patterns of care, and unsafe conditions that increase risks and 
hazards to patients. Definitions and other details about PSOs and 
patient safety work product are included in the Patient Safety Act and 
Patient Safety Rule which can be accessed electronically at: http://
www.pso.ahrq.gov/legislation/.

Definition of Common Formats

    The term ``Common Formats'' refers to the common definitions and 
reporting formats, specified by AHRQ, that allow health care providers 
to collect and submit standardized information regarding patient 
quality and safety to PSOs and other entities. The Common Formats are 
not intended to replace any current mandatory reporting system, 
collaborative/voluntary reporting system, research-related reporting 
system, or other reporting/recording system; rather the formats are 
intended to enhance the ability of health care providers to report 
information that is standardized both clinically and electronically.
    In collaboration with the interagency Federal Patient Safety 
Workgroup (PSWG), the National Quality Forum (NQF), and the public, 
AHRQ has developed Common Formats for three settings of care--acute 
care hospitals, skilled nursing facilities, and community pharmacies--
in order to facilitate standardized data collection and analysis. The 
scope of Common Formats applies to all patient safety concerns 
including: Incidents--patient safety events that reached the patient, 
whether or not there was harm; near misses or close calls--patient 
safety events that did not reach the patient; and unsafe conditions--
circumstances that increase the probability of a patient safety event.
    AHRQ's Common Formats for patient safety event reporting include:
     Event descriptions (definitions of patient safety events, 
near misses, and unsafe conditions to be reported);
     Specifications for patient safety aggregate reports that 
derive from event descriptions;
     Delineation of data elements and algorithms to be used for 
collection of adverse event data to populate the reports; and
     Technical specifications for electronic data collection 
and reporting.
    The technical specifications promote standardization of collected 
patient safety event information by specifying rules for data 
collection and submission, as well as by providing guidance for how and 
when to create data elements, their valid values, conditional and go-to 
logic, and reports. These specifications will ensure that data 
collected by PSOs and other entities have comparable clinical meaning. 
They also provide direction to software developers, so that the Common 
Formats can be implemented electronically, and to PSOs, so that the 
Common Formats can be submitted electronically to the PSO Privacy 
Protection Center (PPC) for data de-identification and transmission to 
the Network of Patient Safety Databases.

Common Formats Development

    In anticipation of the need for Common Formats, AHRQ began their 
development by creating an inventory of functioning private and public 
sector patient safety reporting systems. This inventory provided an 
evidence base to inform construction of the Common Formats. The 
inventory included many systems from the private sector, including 
prominent academic settings, hospital systems, and international 
reporting systems (e.g., from the United Kingdom and the Commonwealth 
of Australia). In addition, virtually all major Federal patient safety 
reporting systems were included, such as those from the Centers for 
Disease Control and Prevention (CDC), the Food and Drug Administration 
(FDA), the Department of Defense (DoD), and the Department of Veterans 
Affairs (VA).
    Since February 2005, AHRQ has convened the PSWG to assist AHRQ with 
developing and maintaining the Common Formats. The PSWG includes major 
health agencies within HHS--CDC, Centers for Medicare & Medicaid 
Services, FDA, Health Resources and Services Administration, Indian 
Health Service, National Institutes of Health, National Library of 
Medicine, Office of the National Coordinator for Health Information 
Technology, Office of Public Health and Science, and Substance Abuse 
and Mental Health Services Administration--as well as the DoD and VA.
    Since the initial release of the Common Formats in August 2008, 
AHRQ has regularly revised the formats based upon public comment. 
First, AHRQ reviews existing patient safety practices and event 
reporting systems. Then, AHRQ works in collaboration with the PSWG and 
Federal subject matter experts to develop and draft the Common Formats. 
In addition, the PSWG assists AHRQ with assuring the consistency of 
definitions/formats with those of relevant government agencies as 
refinement of the Common Formats continues. Next, AHRQ solicits 
feedback from private sector organizations and individuals. Finally, 
based upon the feedback received, AHRQ further revises the Common 
Formats.
    Participation by the private sector in the development and 
subsequent revision of the Common Formats is achieved through working 
with the NQF. The Agency engages the NQF, a non-profit organization 
focused on health care quality, to solicit comments and advice 
regarding proposed versions of the Common Formats. AHRQ began this 
process with the NQF in 2008, receiving feedback on AHRQ's 0.1 Beta 
release of the Common Formats for Event Reporting--Hospital. After 
receiving public comment, the NQF solicits the review and advice of its 
Common Formats Expert Panel and subsequently provides feedback to AHRQ. 
The Agency then revises and refines the Common Formats and issues them 
as a production version. AHRQ has continued to employ this process for 
all subsequent versions of the Common Formats.
    In 2014, representatives from U.S. community pharmacies approached 
AHRQ regarding collaboration to develop Common Formats for the 
community pharmacy setting. Development of the new Formats began using 
the existing AHRQ Common Formats Medication module from the AHRQ Common 
Formats for Event

[[Page 92818]]

Reporting--Hospital, Version 1.2, as a starting point. AHRQ, in 
conjunction with community pharmacy representatives, designed these new 
formats to facilitate improved detection and understanding of 
medication-related events originating in pharmacies. If implemented as 
specified, the Common Formats--Community Pharmacy Version 1.0 will 
allow aggregation of medication-related data across different pharmacy 
providers.
    On October 6, 2015, AHRQ announced the availability of the--Common 
Formats Retail Pharmacy Version 0.1 Beta--for review and comment in the 
Federal Register (80 FR 60385-60387). After obtaining feedback from 
both the private and public sectors, the Agency finalized the format 
and renamed it Common Formats--Community Pharmacy Version 1.0. All 
elements--including the event description, aggregate reports, data 
elements and algorithms, and technical specifications--will be posted 
at the PSOPPC Web site: https://www.psoppc.org/psoppc_web.
    More information on the Common Formats can be obtained through 
AHRQ's PSO Web site: http://www.pso.ahrq.gov/.

Sharon B. Arnold,
Deputy Director.
[FR Doc. 2016-30604 Filed 12-19-16; 8:45 am]
 BILLING CODE 4160-90-P