tag:blogger.com,1999:blog-7323692122514281455.post270079862996201908..comments2024-03-22T17:05:55.267-04:00Comments on MD Whistleblower: Electronic Medical Records: Medical Malpractice Shield or Magnet?Michael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger17125tag:blogger.com,1999:blog-7323692122514281455.post-49150540280708937602012-06-15T09:26:36.425-04:002012-06-15T09:26:36.425-04:00Great article Mike,I definitely agree with you and...Great article Mike,I definitely agree with you and LeisureGuy, that the tort system is not the answer. I found your blog about EMR while searching online for <a href="http://www.systems4pt.com/documentation" rel="nofollow">physical therapy documentation</a> software. I'm happy I did though cause you definitely addressed a important topic, thanks for the good read Mike.Kate Dunkinhttps://www.blogger.com/profile/13662900147365599971noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-64855174181692153362011-02-10T09:55:20.445-05:002011-02-10T09:55:20.445-05:00This is such a great post.This is such a great post.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-53021283982476880702011-01-18T01:59:13.518-05:002011-01-18T01:59:13.518-05:00Nice post! I enjoyed reading your post. Anyway, Th...Nice post! I enjoyed reading your post. Anyway, The right electronic medical records software system can save a physician practice time and money, while also improving patient outcomes.That's the reason why many wants to have their own electronic medical records software system. Keep posting.<br /><br />-krisha-electronic medical recordshttp://www.acrendo.com/noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-16079837713204839042011-01-11T03:18:35.906-05:002011-01-11T03:18:35.906-05:00So basically, most of you guys are telling that th...So basically, most of you guys are telling that this so called "tort" does not entirely promote reform to monitor and put necessary laws to prevent malpractice.malpractice liability insurancehttp://www.malpracticeinsurancedirectory.com/ar/malpractice-liability-insurance.phpnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-87663583389508846382011-01-04T20:48:50.569-05:002011-01-04T20:48:50.569-05:00You should look into a web-based EMR
system that ...You should look into a <a href="http://www.practicefusion.com?utm_source=comment&utm_medium=blog&utm_campaign=PFLS" rel="nofollow">web-based EMR</a><br /> system that offers a much more intuitive and user-friendly alternative to a traditional type EMR. While it will always be a challenge for those used to charting by hand, there are many ways to work around the costly installation and upkeep that traditional vendors require.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-73559471926660105762011-01-04T19:54:16.428-05:002011-01-04T19:54:16.428-05:00Certainly copy and paste can be used in a bad way,...Certainly copy and paste can be used in a bad way, but so can a ton of other things in a medical practice. I think you'll find this post by Dr. West interesting where he outlines how copy and paste can actually help him to be a better doctor: http://www.emrandhipaa.com/emr-and-hipaa/2010/11/22/is-cut-and-paste-in-ehr-software-really-such-a-bad-thing/<br /><br />I fear that many of your concerns over EMR and its use stem more from poorly implemented EMR software than anything else.EMR and HIPAAhttp://www.emrandhipaa.comnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-9588994816364468912010-12-22T01:00:39.093-05:002010-12-22T01:00:39.093-05:00"Other viewpoints are not purely held and are..."Other viewpoints are not purely held and are clearly contaminated by self-interest".<br /><br />Yeah, yours are a prime example of that.<br /><br />"I conclude from your comment regarding the medical liability system (or whatever terminology you choose)is functioning well and needs no reform, or even reexamination. I disagree".<br /><br />What medical liability system are you dreaming up? You were told repeatedly, like a child who is scolded not to smear his dirty fingers all over the walls that no such system exists, only a civil liability system - you don't get a different system than everyone else. You are still adament to tell us about this fairy tale system.<br /><br />You want your own "special" courts aka foxes guarding the hen houses. Good luck getting past the 7th amendment (right to a civil jury trial).<br /><br /><br />As far as making the system more efficient, I have a few suggestions...<br /><br />1) Streamline discovery by getting the same judge to monitor it throughout the lawsuit. This will remove a liable defendant's incentive to drag out litigation for years for no reason. Force both sides to come up with a "SCOPE OF DISCOVERY" and stick to it.<br /><br />This will allow meritorious claims to go through and kick bad ones out, although in my state you need an expert witness to sign off on a lawsuit before you can even file it, so all are at least potentially meritorious.<br /><br />2) Implement stringent expert witness standards as seen in numerous states already. I would base this on a plaintiff/ defendant past testimony ratio.. If you have an expert who only testifies for one side, dont even let the jury discredit him (which they would) save the time by not allowing him in<br /><br /><br />What needs reform is DISCOVERY ( the long, overly burdensome process of acquiring evidence). Once reformed, you could get in and out of court quickly.Diff Anonnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-1903192435404156182010-12-19T09:32:35.602-05:002010-12-19T09:32:35.602-05:00It has advocated and a great deal of emphasis is b...It has advocated and a great deal of emphasis is being placed n the use of an electronic medical record to reduce errors and duplications, as well as increase patient safety.<br /><br />Owing to a better need to increase efficiency inside the medical offices, many medical practitioners are searching for software that will be able to take care of all of their client needs. <a href="http://www.healthtec-software.com/electronic-medical-records.htm" rel="nofollow">Electronic Medical Records</a> are in fact a vital case and should be treated as precious as a patient’s life may be ruined in no time.Healthtec Softwarehttps://www.blogger.com/profile/13070460733184099472noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-85620257346596198702010-12-05T09:49:18.440-05:002010-12-05T09:49:18.440-05:00I have found that quite seldom is there any direct...I have found that quite seldom is there any direct response to arguments and statistics that I post here, so I am grateful to A. Bailey for responding, even though I don't believe he could have read what I posted in this discussion: no quotes from The Nation (I don't read it anyway), but rather quotes from newspapers recounting the problems from which the lawyer discussions are intended to distract us. I like factual input.LeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-80845513768667173712010-11-30T07:20:49.294-05:002010-11-30T07:20:49.294-05:00Leisure Guy's comments, directed at a solo off...Leisure Guy's comments, directed at a solo office-based practitioner, are irrelevant, but most of his musings here are anyway. If he wanted some fair-minded input, he could google James Reason and review some of his well thought-out literature. But he'll probably just cuddle with his back issues of The Nation instead.A. Baileynoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-41653203471198507762010-11-29T11:57:49.377-05:002010-11-29T11:57:49.377-05:00Since you haven't defined "well", I ...Since you haven't defined "well", I have no idea what you're concluding. Until you set some baselines for what you mean by "well", it's impossible to discuss the issue from that perspective.<br /><br />We know you disagree. You have stated those two points of disagreement ad nauseum. What you haven't stated is how the reforms you've supported in the past address either of those, nor how any future reforms you're proposing address those. Without infringing on the US Constitution, of course.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-25444326058468493242010-11-29T11:44:43.388-05:002010-11-29T11:44:43.388-05:00@anonymous: I conclude from your comment regarding...@anonymous: I conclude from your comment regarding the medical liability system (or whatever terminology you choose)is functioning well and needs no reform, or even reexamination. I disagree.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-26162952914698459462010-11-29T09:47:52.170-05:002010-11-29T09:47:52.170-05:00"It is astonishing that people can defend a m..."It is astonishing that people can defend a medical liability system that "<br /><br />It remains astonishing that you believe there is a "medical liability system". There is not. You have been told this repeatedly, but choose to ignore it. Why, I don't know.<br /><br />There is a civil justice system, and it adjudicates claims brought to it. Your criticism that it doesn't catch more negligence is frankly a ludicrous one, because neither physicians nor their insurers WANT all incidents of negligence reported, much less to pay the damages resulting from them.<br /><br />Your complaint that it "ensnares" more "innocent" physicians than it should is also ludicrous, because any body that investigates complaints against physicians for negligence is almost certainly going to review more claims than it finds warranted.<br /><br />You know these things. Yet you continue to act as if they don't exist. Why? And the only "reform" you've supported has literally nothing to do with either of those complaints. Which causes them to ring hollow.<br /><br />As for the standard of care, that is up to physicians. If physicians want to promulgate standards of care, indeed even set up a body to do this, there is literally nothing stopping them. Zero. Zip. So criticizing the civil justice system for not doing something that is exclusively within the purview of medicine seems, to overuse a word, ludicrous as well.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-18719167736173539472010-11-28T10:22:34.740-05:002010-11-28T10:22:34.740-05:00Another interesting story in this morning's LA...Another interesting story in this morning's LA Times: "'Error-free' hospitals scrutinized" (http://goo.gl/X1tFt). From the story:<br /><br />"California public health officials are scrutinizing hospitals that claim to be error-free, questioning whether nearly 90 facilities have gone more than three years without any significant mistakes in care.<br /><br />"Eighty-seven hospitals — more than 20% of the 418 hospitals covered under a law that took effect in 2007 — have made no reports of medical errors, according to the California Department of Public Health.<br /><br />"The high percentage has raised concerns that errors have gone unreported. Some patient advocates say it is an indication that hospitals are unwilling to police themselves. State officials have given hospitals until Tuesday to verify their records as error-free or to report errors, as required by law.<br /><br />"Jamie Court, president of the Santa Monica-based advocacy group Consumer Watchdog, called it "almost inconceivable" that so many hospitals were error-free for the last three years.<br /><br />""This is a see-no-evil, hear-no-evil problem. If you're not looking, you're not going to find any," Court said. "But if you are looking, you're more than likely to find some, regardless of the size of the hospital.""<br /><br />More at the link. I think this is a real-time example of how the problem is created and maintained by the medical profession. The lawsuit problem is a side-effect. To actually cure the problem, it must be tackled at the root cause. The fact that so many doctors have problems understanding this idea does not bode well for their diagnoses of medical problems: apparently they treat the symptom, not the disease.LeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-68812039778619729512010-11-28T10:16:17.142-05:002010-11-28T10:16:17.142-05:00@A. Bailey: From the Washington Post article I cit...@A. Bailey: From the Washington Post article I cited above:<br /><br />"Why aren't hospitals leaping to adopt these best practices?.... More than half of the 2,075 respondents, most of whom were infection control nurses employed by hospitals, reported that they use a cumbersome paper-based system for tracking patients' conditions that makes it harder to spot infections in real time. Seven in 10 said they are not given enough time to train other hospital workers on proper procedures. Nearly a third said enforcing best practice guidelines was their greatest challenge, and one in five said administrators were not willing to spend the necessary money to prevent CRBSIs.<br /><br />"[Peter] Pronovost said part of the problem was that <em>many hospital chief executives aren't even aware of their institution's bloodstream infection rates, let alone how easily they could bring them down</em>. When hospital leaders decide to create a culture in which preventing infections is a priority, he added, <em>nurses feel empowered to remind physicians to follow the checklist when inserting catheters</em>, physicians are provided antiseptic soaps as part of their catheter kits and infection control personnel have the best tools to monitor patients."<br /><br />Emphasis added.<br /><br />Hope this helps.LeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-33631958158186571762010-11-28T10:09:37.924-05:002010-11-28T10:09:37.924-05:00I totally agree that the tort system is a very ine...I totally agree that the tort system is a very inefficient answer that, as you point out, misses most of the harm caused and doesn't seem to lead to reform.<br /><br />Why do we even have this system and why does it keep fielding cases?<br /><br />It seems simple to me: the system we have is the only recourse given that the medical profession as a whole refuses to take any constructive action (beyond attacking lawyers, of course: "Look over there! Look what those lawyers are doing!!"<br /><br />But how about this story from the NY Times: "Study finds no progress in safety at hospitals". (http://goo.gl/L0JAJ) Don't you think that's probably a greater cause of medical malpractice than lawyers responding to their client's complaints about medical treatment? (The Washington Post version, titled "Hospital infection deaths caused by ignorance and neglect, survey finds" (http://goo.gl/YHnpR))<br /><br />I think that you continue to exclaim and complain about a mote in the eyes of lawyers while the medical profession has a beam in its own eye: the adamant refusal to discipline and then ban problem doctors and the adamant refusal to adopt best practices. Until those are cured, I feel certain that medical malpractice will continue to occur and thus medical malpractice lawsuits will follow (inefficiently) in their wake.<br /><br />The onus of responsibility falls squarely on the medical profession.LeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-2865576764864938742010-11-28T10:07:33.353-05:002010-11-28T10:07:33.353-05:00Yikes! Those of us who are clinging for dear life ...Yikes! Those of us who are clinging for dear life to paper charts would be liable for WHAT reason? I didn't realize being a Luddite was grounds for a lawsuit.A. Baileynoreply@blogger.com