The Future of Healthcare-- Granting Access to Innovation in America Act (GAIA Act) - Authorizes the Secretary of Health and Human Services to make grants to hospitals and skilled nursing facilities to carry out demonstration projects aimed at reducing the rate of medication errors and improving the quality of care by installing or upgrading computerized technology that: (1) provides information on drug-allergy contraindications and drug interactions; (2) ensures that all drug orders are legible; and (3) provides physicians and other clinicians with a menu of medications, complete with default doses and a range of potential doses for each medication.
Requires grant applicants to agree to provide for technology including software that assists clinicians who order prescription drugs and tests in making medication-related decisions and that provides for an electronic medication administration record. Authorizes grant expenditures to purchase, install, and update such technology. Sets forth matching requirements.
Requires each applicant to agree to submit to the Secretary, acting through the National Health Information Technology Coordinator, a report detailing: (1) quantitative reductions in medication errors; (2) the level of staff compliance; (3) the difference between administrative and clinical workflows before and after implementation of the technology; (4) alterations and improvements regarding the workflow in facilities that have the technology; (5) an analysis of the improvement of the quality of care and patient satisfaction within the hospital or skilled nursing facility involved; and (6) the overall economic savings associated with usage of the technology.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3607 Introduced in House (IH)]
109th CONGRESS
1st Session
H. R. 3607
To improve the quality of health care through the implementation of
computerized provider order entry systems in hospitals and skilled
nursing facilities that will result in a reduction in the rate of
medication errors and in redundancies and will create more efficiency.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 28, 2005
Mr. Sweeney introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To improve the quality of health care through the implementation of
computerized provider order entry systems in hospitals and skilled
nursing facilities that will result in a reduction in the rate of
medication errors and in redundancies and will create more efficiency.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``The Future of Healthcare--Granting
Access to Innovation in America Act (GAIA Act)''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Medical errors, such as the miscalculation of
prescribed dosage amounts and the illegible handwriting of
physicians, cause many unnecessary deaths in the United States
each year.
(2) There are 98,000 preventable deaths that occur each
year from medication errors in the United States.
(3) According to a 2004 Health Grades report on patient
safety in American hospitals, medication errors are the 6th
leading cause of death among patients in hospitals in the
United States.
SEC. 3. IMPLEMENTATION OF COMPUTERIZED PROVIDER ORDER ENTRY TECHNOLOGY.
(a) In General.--The Secretary of Health and Human Services, in
consultation with the Administrator of the Centers for Medicare &
Medicaid Services and with the National Health Information Technology
Coordinator, may make grants to hospitals and skilled nursing
facilities to carry out demonstration projects for the purpose of
reducing the rate of medication errors and improving the quality of
care in the hospitals and skilled nursing facilities by installing or
upgrading computerized technology that assists in preventing such
errors and that increases the quality of care through capabilities such
as the following:
(1) Providing information on drug-allergy contraindications
and interactions between drugs.
(2) Ensuring that all drug orders are legible.
(3) Providing physicians and other clinicians with a menu
of medications, complete with default doses and a range of
potential doses for each medication.
(b) Requirements Regarding Decision-Support Software.--
(1) In general.--With respect to the computer technology
described in subsection (a) (referred to in this section as
``CPOE technology''), a grant may be made under such subsection
only if the applicant involved agrees--
(A) for grants made pursuant to subsection
(l)(2)(A) to ensure that when the CPOE technology
involved becomes operational, the software described in
paragraph (2) has been installed for use with the CPOE
technology; or
(B) for a grant made pursuant to subsection
(l)(2)(B) that is an initial grant referred to in such
subsection, to ensure that such software is installed
for use with the CPOE technology not later than one
year after the receipt of the initial grant under
subsection (a).
(2) Description of software.--For purposes of paragraph
(1), the software described in this paragraph is computer
software that assists physicians and clinicians who order
prescription drugs and tests in making medication-related
decisions through functions such as the following:
(A) Providing computerized advice regarding drug
doses, selection, duration, and frequencies.
(B) Performing drug-allergy checks, drug-
laboratory-value checks, and checks on interactions
between drugs.
(C) Providing reminders with respect to corollary
orders or drug guidelines.
(D) Incorporating patient-specific or pathogen-
specific information.
(c) Requirements Regarding Electronic Medication Administration
Record.--
(1) In general.--A grant may be made under subsection (a)
only if the applicant involved agrees--
(A) for grants made pursuant to subsection
(l)(2)(A) to ensure that when the CPOE technology
involved becomes operational, the software described in
paragraph (2) has been installed for use with the CPOE
technology; or
(B) for a grant made pursuant to subsection
(l)(2)(B) that is an initial grant referred to in such
subsection, to ensure that such software is installed
for use with the CPOE technology not later than one
year after the receipt of the initial grant under
subsection (a).
(2) Description of software.--For purposes of paragraph
(1), the software described in this paragraph is software
providing for an electronic record known as an electronic
medication administration record (also known as EMAR) and is a
fully closed-loop medication process that, for the patient
involved, electronically documents the specific drug, dosages,
routes and times for the administration of medication, and acts
as a scheduler by linking to a pharmacy information system
through a bar-code point-of-care system.
(d) Certain Uses of Grant.--The purposes for which a grant under
subsection (a) may be expended include the following:
(1) Purchasing and installing CPOE technology.
(2) Purchasing and installing decision-support software and
EMAR for purposes of subsections (b) and (c).
(3) Updating CPOE technology, decision-support software,
and EMAR.
(4) Training and updating the usage associated with CPOE
technology, decision support software, and EMAR with the goal
of attaining a 100 percent rate of compliance among physicians
and other clinicians who order prescription drugs and tests.
(e) Facilities With Previously Installed CPOE Technology.--A grant
under subsection (a) may be made to a hospital or a skilled nursing
facility that installed CPOE technology prior to receiving an initial
grant under such subsection. Such a hospital or facility may expend the
grant for the purposes described in paragraphs (2) through (4) of
subsection (d).
(f) Matching Requirement.--
(1) In general.--A grant may be made under subsection (a)
only if the applicant involved agrees that, with respect to the
costs to be incurred by the applicant in carrying out the
purpose described in such subsection, the applicant will make
available non-Federal contributions (in cash or in kind) toward
such costs in an amount determined by the Secretary. Such
contributions may be made directly or through donations from
public or private entities.
(2) Determination of amount of non-federal contribution.--
Non-Federal contributions required in subsection (a) may be in
cash or in kind, fairly evaluated, including equipment or
services (and excluding indirect or overhead costs). Amounts
provided by the Federal Government, or services assisted or
subsidized to any significant extent by the Federal Government,
may not be included in determining the amount of such non-
Federal contributions.
(g) Reports by Hospitals and Skilled Nursing Facilities.--A grant
may be made under subsection (a) only if the applicant involved agrees
that, for each fiscal year for which the grant is made, the applicant
will submit to the Secretary, acting through the National Health
Information Technology Coordinator, a report that provides details on
the following:
(1) Quantitative reductions in medication errors.
(2) The level of compliance by physicians, clinicians, and
other staff with respect to the usage of CPOE technology.
(3) The difference between administrative and clinical
workflows before the implementation of CPOE technology and
after the usage of such technology.
(4) Alterations and improvements with respect to workflow
in the case of facilities that have CPOE technology.
(5) An analysis on the improvement of the quality of care
and patient satisfaction within the hospital or skilled nursing
facility involved.
(6) The overall economic savings associated with the usage
of CPOE technology.
(h) Application.--A grant may be made under subsection (a) only if
an application for the grant is submitted to the Secretary and the
application is in such form, is made in such manner, and contains such
agreements, assurances, and information as the Secretary determines to
be necessary to carry out this section. The Secretary shall provide
technical assistance to hospitals and skilled nursing facilities in the
application process.
(i) Limitation of Grant.--A grant under subsection (a) may not be
made in an amount exceeding $500,000.
(j) Report to Congress.--Not later than five years after the
initial distribution of grants under subsection (a), the Secretary
shall submit to the Congress a report on the progress of the program
under such subsection.
(k) Definitions.--For purposes of this Act:
(1) The term ``barcode point-of-care'' means a system that
uses bar codes in association with a computer server that
interfaces with the admission, discharge, transfer, and
pharmacy systems, and with EMAR software, in order to ensure
that a patient receives the medications intended for the
patient, including the intended dosages.
(2) The term ``CPOE technology'' has the meaning indicated
for such term in subsection (b)(1).
(3) The term ``decision-support software'' means the
computer software described in subsection (b)(2).
(4) The terms ``electronic medication administration
record'' and ``EMAR'' have the meaning indicated for such terms
in subsection (c)(2).
(5) The term ``rural hospital'' means a hospital located in
a rural area, as defined in section 1886(d)(2)(D) of the Social
Security Act.
(6) The term ``rural skilled nursing facility'' means a
skilled nursing facility located in a rural area, as defined in
section 413.333 of title 42, Code of Federal Regulations.
(7) The term ``Secretary'' means the Secretary of Health
and Human Services.
(8) The term ``skilled nursing facility'' has the meaning
indicated for such term in section 1819(a) of the Social
Security Act.
(l) Funding.--
(1) Authorization of appropriation.--For the purpose of
carrying out this section, there is authorized to be
appropriated $25,000,000 for each of the fiscal years 2006
through 2010.
(2) Reservation of amounts.--Of the amounts appropriated
under paragraph (1), the Secretary shall reserve amounts in
accordance with the following:
(A) Fifty percent for grants under section (a) for
the initial purchase and installation of CPOE
technology and decision-support software. Amounts
reserved under this subparagraph are not available for
hospitals and skilled nursing facilities referred to in
subsection (e) and are not available for the purposes
described in paragraphs (3) and (4) of subsection (d).
(B) Fifty percent for grants under such subsection
for upgrading such technology and software and for
other purposes authorized in paragraphs (2) through (4)
of subsection (d), including initial and subsequent
grants under subsection (a) to hospitals and skilled
nursing facilities referred to in subsection (e).
(C) Twenty percent for grants under such subsection
to rural hospitals and rural skilled nursing facilities
in the aggregate, which percentage includes amounts
reserved under subparagraphs (A) and (B) that are used
for grants under subsection (a) to rural hospitals and
rural skilled nursing facilities.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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