H.C.R. NO.


















WHEREAS, thousands of patients die unnecessarily each year in hospitals from unexpected accidents and errors that include insufficient staffing and ineffective systems in place to identify acute care hospital medical-surgical patients in distress; and

WHEREAS, each year approximately two hundred thousand people die in hospitals in the United States from preventable errors and mistakes; nearly twenty per cent of those deaths occur from failure-to-rescue; and†

WHEREAS, a Patientís Right to Safety is an emerging legal entitlement and national standard-of-care for every acute care hospital patient; and


WHEREAS, the Hawaii Employer-Union Health Benefits Trust Fund conducted a two-year pilot project at the Queens Medical Center using the Intelligent Medical Vigilance technology and found a thirty-five per cent return on investment when a reimbursement of $18.00 per day, per bed, was paid; and


WHEREAS, in the same pilot project, the Hawaii Employer-Union Health Benefits Trust also found an 18.5 per cent reduction of intensive care unit transfers and a forty-one per cent reduction of fall rates on the medical surgical ward; and


WHEREAS, the medical-surgical units and nursing stations of a typical acute care hospital are where most patients receive non-critical care, generally involving regularly scheduled nursing rounds every four to eight hours; however, acute or unexpected clinical events may go unnoticed for critical minutes or hours until the next visit by a physician or nurse; and

WHEREAS, although rapid response teams are being promoted as a solution to address acute clinical events, there are no systems focused on the medical-surgical ward of the acute care hospital, where nearly seventy-five per cent of patients typically receive care, to identify and track patients in distress; and††

WHEREAS, technology solutions have been advocated to augment patient safety on the medical-surgical wards of acute care hospitals; and

WHEREAS, an automated early alert system called the LIFEBED Intelligent Medical Vigilance System or LIFEBED, identifies at-risk patients with an invisible, non-contact "Star Trek-like" device that provides accurate and continuous observations of heart and respiratory rates -- the two most critical vital signs --† while the patient is in bed, and notifies nursing staff immediately upon detecting a life-threatening condition; and

WHEREAS, LIFEBED also detects a patient's unauthorized bed exit, a leading cause of injurious and expensive patient falls; and†

WHEREAS, LIFEBED has been developed, tested, and validated in clinical settings and has received United States Food and Drug Administration authorization specifically for medical-surgical applications in acute care hospitals; and


WHEREAS, LIFEBED provides non-contact physiological measurements, eliminating the need for cumbersome direct patient connections, such as electrodes, cuffs, or cannulae, immediately notifying nursing personnel of important information for at-risk patients, which allows proactive response before an unexpected event becomes serious or fatal; and

WHEREAS, LIFEBED enables more efficient use of resources and staff, permitting nursing staff to be aware of, and respond to, precipitous patient deterioration.† As a virtual additional set of eyes, LIFEBED monitors a patient constantly and calls the nurses for help only if the patient is at serious risk; and

WHEREAS, this critical capability will enable LIFEBED to become a standard-of-care for medical-surgical units in acute care hospitals; and


WHEREAS, because of the absence of health insurance coverage for the use of LIFEBED, many hospitals may be reluctant to provide LIFEBED to their patients; and


WHEREAS, section 23‑51, Hawaii Revised Statutes, requires that "[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage"; and


†††† WHEREAS, section 23-51, Hawaii Revised Statutes, further provides that "[t]he concurrent resolutions shall designate a specific legislative bill that:


†††† (1)† Has been introduced in the legislature; and


†††† (2)† Includes, at a minimum, information identifying the:


(A)† Specific health service, disease, or provider that would be covered;


(B)† Extent of the coverage;


(C)† Target groups that would be covered;


(D)† Limits on utilization, if any; and


(E)† Standards of care.


For purposes of this part, mandated health insurance coverage shall not include mandated optionals"; and


†††† WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the Auditor's report; and


†††† WHEREAS, H.B. No. 854 (2011) mandates coverage of the use of the LIFEBED Intelligent Medical Vigilance System for all policies and contracts, hospital and medical service plan contracts, medical service corporation contracts, and health maintenance organization plans and contracts issued on or after December 31, 2011; and


†††† WHEREAS, the Legislature believes that mandatory health insurance coverage for use of the LIFEBED Intelligent Medical Vigilance System as provided in H.B. No. 854 (2011), would substantially reduce illnesses and injuries and assist in the maintenance of good health for the people of this State; now, therefore,


†††† BE IT RESOLVED by the House of Representatives of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2011, the Senate concurring, that the Auditor is requested to conduct an impact assessment report, pursuant to sections 23‑51 and 23‑52, Hawaii Revised Statutes, of the social and financial impacts of mandating coverage of the use of the LIFEBED Intelligent Medical Vigilance System for all policies and contracts, hospital and medical service plan contracts, medical service corporation contracts, and health maintenance organization plans and contracts issued on or after December 31, 2011, as provided in H.B. No. 854 (2011); and


†††† BE IT FURTHER RESOLVED that the Auditor is requested to submit findings and recommendations to the Legislature, including any necessary implementing legislation, no later than twenty days prior to the convening of the Regular Session of 2012; and


†††† BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and to the Insurance Commissioner, who in turn is requested to transmit copies to each insurer in the State that issues health insurance policies.









Report Title:†

Mandatory Coverage for LIFEBED Intelligent Medical Vigilance System; Auditor Study