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New-Age Physician Risks Courtesy of Health Information Technology

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Issues You May Not Have Considered

By David K. Luke MIM, Certified Medical Planner™

www.CertifiedMedicalPlanner.org

The entire nation continues to experience a medical malpractice liability crisis.

Facing physicians is the concern of frequency and severity of claims that either continues to rise or remains steady. And, much has been written about the impact of the liability crisis on physicians, the medical community, patients and access to care.

But, with health 2.0 connectivity, there are even more risks for doctors, and most all medical professionals, to consider.

So, here are a few fresh liability risks to your medical practice, to you, and to your patients courtesy of the health information age:

  1. Data breech risk. While not a new risk, the higher prevalence is new. The risks of a being fined by OCR due to the privacy rules of HIPAA because a practice had a data-breech with their EHR is becoming more common and very expensive
  2. Risks of telemedicine. As physicians become more technologically enabled in their practice of medicine, some are turning to real-time videoconferencing and other technologies. Some specialties such as psychiatry have been early adopters, but have to make sure they are still employing the same standards of care required by an in office visit (Cash 26). Also, the telephone can facilitate medical care but also result in adverse outcomes leading to telephone-related malpractice suits (Mondor, et al 517).
  3. Risks of new age medicine practices and their regulation. Case in point: Dry needling, which is like acupuncture, is a growing practice in places like Australia but is unregulated. Physicians should understand all regulatory and other risks when implementing new unregulated practices pushed by our new age society (Janz). Home births are on the rise in North America (even in Canada with government provided hospital delivery) but physicians end up dealing with the disasters and associated risks when they occur (Bochove 68).
  4. Reputation Risk. Reputation is a doctor’s most valuable asset. With the new age of internet and instant information, physicians must take great care in managing their reputation on such media sources as they are under increasing public and press scrutiny (Boyd 221).
  5. Communication risks to immigrants with limited non-native language proficiency. With today’s higher immigrant population in the United States, more medical practices are treating patients with limited English language proficiency. Clinicians now run the risk of not properly communicating medical risk information to these populations. A recent study shows that materials that include visual aids are being used by medical practices to effectively communicate with the patient (Garcia-Retamero, Rocio, and Mandeep, K. Dhami 47).
  6. The rise of the informed distrusting patient and related risks. With the ubiquity of medical information on the internet, the risks incurred by a medical practice in properly dealing with the newly informed patients with medical degrees from the University of Google Medical School are on the rise. Physicians must refine their “bed side manner” and improve their communication skills in order to deal with a more questioning patient population. Clinicians should actively discuss what patients have read on the internet when patients refer to their internet diagnoses (Lam-Po-Tang, John, and Diana McKay 130).

Works Cited

  • Bochove, Danielle. “Don’t Try This At Home.” Maclean’s 124.33/34 (2011): 68. MasterFILE Premier. Web. 27 Apr. 2012.
  • Boyd, M. “Managing Risk To Reputation.” Clinical Risk 15.6 (2009): 221-223. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Cash, Charles, D. “Telepsychiatry And Risk Management.” Innovations In Clinical Neuroscience 8.9 (2011): 26-30. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Garcia-Retamero, Rocio, and Mandeep, K. Dhami. “Pictures Speak Louder Than Numbers: On Communicating Medical Risks To Immigrants With Limited Non-Native Language Proficiency.” Health Expectations 14.(2011): 46-57. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Janz, StephenAdams “Acupuncture by Another Name: Dry Needling in Australia.” Australian Journal Of Acupuncture & Chinese Medicine 6, no. 2: 3-11. Alt HealthWatch, EBSCOhost. Web. 27 Apr. 2012
    • Lam-Po-Tang, John, and Diana McKay. “Dr Google, MD: A Survey Of Mental Health-Related Internet Use In A Private Practice Sample.” Australasian Psychiatry 18.2 (2010): 130-133. Academic Search Complete. Web. 27 Apr. 2012.
    • Maureen Mondor, et al. “Patient Safety And Telephone Medicine.” JGIM: Journal Of General Internal Medicine 23.5 (2008): 517-522. Academic Search Complete. Web. 27 Apr. 2012

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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9 Responses

  1. 5 HIT areas to avoid adverse effects on patients

    Certain oversights during the technology implementation process could have adverse effects on patients.

    Here are 5 HIT areas that could potentially impact patient care if not handled in a mindful manner.

    http://www.physbiztech.com/how-to/be-mindful-these-5-hit-areas-avoid-adverse-effects-patients

    Ann Miller RN MHA

    Like

  2. Ann and Mr. Luke

    As Dr. Marcinko wrote in his book: “It’s not just about medical malpractice anymore.”
    Informative essay and comments. Thanks.

    Dr. Belinsky

    Like

  3. ADA Settlement After CA Podiatrist Refused to Perform Surgery on HIV Patient

    The Justice Department announced that it has reached a settlement today resolving a claim that a healthcare provider refused to serve people with HIV in violation of the Americans with Disabilities Act (ADA).

    The complaint was filed by a man with HIV who went to the Mercy Medical Group Midtown Clinic in Sacramento, CA. After meeting with the patient and examining him, a podiatrist at the clinic informed the patient of his treatment options. Although surgery was one of the treatment options, the podiatrist incorrectly told the patient that he could not perform the surgery because of a risk that he would contract HIV from the patient during surgery.

    The United States determined that the podiatrist’s actions violated the ADA by denying the patient the full and equal enjoyment of the services offered at the clinic on the basis of his disability. The settlement agreement requires the entities to develop and implement a non-discrimination policy and to train staff on the requirements of the ADA. In addition, Mercy Medical Group and CHW Medical Foundation are required to pay $60,000 to the complainant and $25,000 as a civil penalty.

    Source: 7thSpace Interactive [5/11/12]
    via PM News #4,461

    Like

  4. Harvard medicine professor – Tech won’t revolutionize care

    While hailed as a “tour de force” by some in the healthcare community, Eric Topol’s book, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care,” is not universally accepted by all medical professionals as an outline for the future of patient care.

    http://www.npr.org/2012/06/01/154148664/can-technology-deliver-better-health-care

    In fact, one of those detractors, Harvard Medical School professor emeritus of medicine and social medicine Arnold Relman MD, expressed doubt that patients would be as motivated to participate in their own care as the book portends in a panel discussion hosted on National Public Radio last week.

    Any thoughts?

    Ann Miller RN MHA

    Like

  5. Privacy – Get over it

    http://www.propublica.org/article/how-a-grad-student-scooped-the-ftc-and-what-it-means-for-your-online-privac

    How a Lone Grad Student Scooped the Government and What It Means for Your Online Privacy

    Lionel

    Like

  6. Are Docs Responsible for EHR Bugs?

    Dr. Marcinko and Mr. Luke

    – Picture this scenario:

    You’ve been sued, and now the plaintiff attorney has the right to send in an expert to sit at your computer and examine information in your EHR. Besides any mistakes you might have made; system-wide bugs or design flaws that lead to data inconsistencies could be found and held against you in the discovery phase of a malpractice lawsuit.

    Truth or fiction?

    Hortense

    ###

    Dear Hortense

    As you know from this ME-P and our books, doctors are becoming increasingly aware that EHRs can create certain malpractice risks.

    However, an expert in EHR and liability says there is a new category of malpractice risks in EHRs that most doctors have never considered. These include EHR system issues that you were never aware of and didn’t cause.

    For example, authorized software upgrades can unknowingly cause liability problems. Upgrades to the software can change the historical data presentation you’ve already worked with.

    So, be afraid of eHRs – be very afraid!

    Dr. David Edward Marcinko MBA
    http://www.amazon.com/Insurance-Management-Strategies-Physicians-Advisors/dp/0763733423/ref=sr_1_3?ie=UTF8&s=books&qid=1275315795&sr=1-3

    Like

  7. HIPAA

    Just last week, “Fear of Data Theft Blunts Public Acceptance of EHRs” by Robert Lowes was posted on Medscape.com.

    http://www.medscape.com/viewarticle/769778

    Darrell K. Pruitt DDS

    Like

  8. AMA Telemedicine Policy Echoes Controversial State Boards’ View

    A physician delivering care via telemedicine should be licensed in the state where the patient is located and the same standards of care that apply to traditional healthcare settings should apply to telemedicine, according to policies approved by the American Medical Association House of Delegates at its annual meeting this week in Chicago.

    The policies were included as recommendations in a report by the AMA Council on Medical Service. The contention that the point of care is the patient’s location and not their doctor’s matches a similar policy passed recently by the Federation of State Medical Boards. That policy had been criticized as slowing the spread of telemedicine by requiring physicians to go through multiple cumbersome and expensive state license-application processes.

    Source: Andis Robeznieks , Modern Healthcare [6/12/14]

    Like

  9. On Tele-Medicine

    “Telemedicine, which provides patients with the ability to see a healthcare provider without leaving the house – via remote communication tools – is increasing in popularity in the healthcare space. This shift from an in-person to digital approach works because it’s clear there is still a human on the other end. If you took away the human and replaced it with a bot, would the level of trust stay the same? Almost certainly not.”

    Ben Ihnchak via Hope R. Hetico RN MHA
    [Partner – Fuzzy Math]

    Like

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