Although there may be disagreement on the exact number of medical errors that occur, no one objects to the magnitude of the problem as reported by the IoM. The IoM Report identifies improved reporting as critical to reducing medical errors. Providers, healthcare administrators, and policymakers cannot resolve what they do not know. Much attention has been directed at whether reporting should be voluntary or mandatory, each with its own implications for implementation. There is some disagreement about whether both mandatory and voluntary reporting is needed as recommended by the IoM. The need for public accountability drove the IoM to recommend mandatory reporting. But whether mandatory or voluntary, the harder question for either system is what to do with the data once they are reported.
States play important roles in both protecting public safety and improving healthcare systems.
The IoM advocates mandatory reporting to States of adverse events, initially by hospitals and eventually by other institutional and ambulatory care delivery settings, some of which will require State enforcement action when the event results in serious harm. States can also play important roles in analyzing and disseminating findings from voluntary reporting systems, although the resources and specialized skills to do so are more demanding. Pooling resources across States may be one approach to effect broad-based change. Physicians express concerns that defining medical errors is not easy because medicine does not always lend itself to standardization. The intent of reporting is to attempt to make improvements by better understanding the mishaps of others.