patient safety Archives - Cravens & Noll

ONC plan aims to protect patients through EHR data analysis alone

David Noll — Mon, 15 Jul 2013 13:48:50 +0000

In a move that has disappointed many safety-minded experts and organizations, the federal government has declined to establish a new agency designed to investigate certain technology-related patient deaths at this time. Rather, the Office of the National Coordinator for Health Information Technology (ONC) is putting in place a collaborative plan to prevent these particular kinds of patient deaths.

Currently, more and more healthcare providers and hospital facilities are shifting towards electronic health records (EHR) instead of paper-based charts. These electronic records are meant to reduce rates of communication-related errors and misdiagnosis. However, the technology itself has the potential to create new kinds of errors resulting from software glitches, implementation challenges and data input problems.

The Institute of Medicine has recommended that the government create a new agency tasked specifically investigating patient deaths tied to EHR-related errors and other technology-based problems. The government is declining to act on this recommendation at this time. Instead, the ONC will work with public and private organizations to attempt to prevent these deaths in the first place.

Prevention of patient deaths through trend-related data analysis is absolutely a goal worthy of pursuit. However, such initiatives fail to address those deaths which have already occurred and continue to occur in a focused way. It seems that both prevention and investigation of tragedy are necessary in order to both foster patient safety in the future and bring justice to the victims of technology-related medical errors.

The ONC is making important progress by embracing its new prevention-related mission. However, targeted investigations into deaths that do occur are necessary for patient safety and justice as well.

Source: Forbes, “Government Asks Health IT Industry To Police Itself On Patient Safety,” Zina Moukheiber, July 5, 2013

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Beware unnecessary medical intervention during pregnancy

David Noll — Mon, 03 Jun 2013 21:46:06 +0000

Being a patient can be an overwhelming experience. On the one hand, you want to trust in your physician’s expertise and follow doctor’s orders in order to help ensure the best possible outcome for your health. On the other hand, most American adults now understand that because physicians are fallible and the medical error rate in the country is staggeringly high, you do not want to consent to procedures, medications and doctor’s orders blindly.

Unfortunately, a recent study suggests that too many American women are being subjected to invasive interventions and other procedures during pregnancy without a full understanding of the hazards involved in this kind of care. Certainly most of these women are simply trusting that their doctor knows best. However, an informed patient is more likely to make choices that are best for her. In addition, avoiding invasive intervention whenever possible helps to lower rates of pregnancy complications and birth injuries.

The recent study was released by the nonprofit maternity care organization Childbirth Connection. The executive director of that organization explained that “Our survey suggests that pregnant women need to take a more active role to make sure they get the care that is best for themselves and their babies. They need access to trustworthy information about the benefits and harms of interventions, to educate themselves, and be their own advocate.”

Why is an active approach to patient care so critical for pregnant women? Because informed patients are less likely to cave to physician pressure in situations that do not warrant invasive and potentially hazardous interventions. In addition, interventions tend to breed additional interventions, so informed patients can often avoid multiple challenging procedures if they are educated about risks and alternatives.

Legal recourse is generally available for patients who are harmed by invasive procedures. But ideally, patients may avoid many of these potentially dangerous procedures in the first place by advocating for themselves in an informed way.

Source: Consumer Reports, “Pregnant? Watch out for unnecessary c-sections and other questionable medical procedures,” Joel Keehn, May 8, 2013

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Grappling with a misguided medical malpractice system

David Noll — Fri, 01 Mar 2013 21:52:00 +0000

Healthcare providers will inevitably make mistakes. Though physicians and nurses are trained to treat every patient in accordance to certain standards of care, healthcare providers are human and will make mistakes from time to time. It is correct that these providers be held accountable for the mistakes they make, should those mistakes cause patients harm. Patients aim to hold providers responsible and obtain the compensation they deserve through medical malpractice claims.

However, the inevitability of mistakes on the part of providers should be informing the functionality of the medical malpractice system more than it currently does now. Based on a physician’s area of expertise, he or she will face a medical malpractice claim every seven years or so. These claims should be processed with appropriate urgency and then if the physician has not behaved so negligently that his or her license is suspended, he or she should then be allowed to return to work informed by the knowledge that his or her mistakes have real consequences.

Unfortunately, the medical malpractice system functions largely without the expectation that nearly all physicians will face malpractice claims over the course of their careers. The legal battles over these claims drag on so long that a recent study published in the journal Health Affairs indicate that 10 percent of any given physician’s medical career will be spent dealing with these claims.

The current structure and procedures governing the medical malpractice system are contributing to patient harm and physician resentment. If the system was more prepared for the fact that physicians will make mistakes and should be held accountable for them, perhaps doctors could practice more medicine and patients could receive their due more quickly and efficiently than they can currently.

Source: Forbes, “Medical Malpractice: Broken Beyond Repair?” Robert Glatter, Feb. 6, 2013

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