So… About Ebola

Ebola and eQuoteMDOkay, we had to go there, right? But don’t worry, this isn’t another piece on 10-Steps-to-Protect-Yourself-from-the-Coming-Pandemic, or 50-Things-You’re-More-Likely-to-Die-From-than-Ebola post. We just thought that Ebola is something that as healthcare professionals our readers will have a unique perspective on, and so maybe it’s worth discussing. As a professional in any field it’s always interesting, and often frustrating when a story that has to do with the specifics of your field breaks into the mainstream news cycle. Things tend to get twisted, distorted, elided, or just plain mixed up. Yet, at the same time there is a real story here. Ebola is real, and it is scary, and we should care about it, but how can we interact with others about it in a way that is professional, helpful, and insightful?

This is a question we imagine a lot of healthcare professionals have. Whether it’s browsing your Facebook feed or reading the op-eds, a conversation with a neighbor or an invitation to speak at a conference, chances are you are aware of both the situation and certain mischaracterizations of the situation. So, have you responded? Which concerns you most? Here are a few that we think are among the most common unhelpful responses: [Read more →]

New Study Shows that Malpractice Reform has Little Impact… Or Does It?

Malpractice Reform, little impact?A new study published by the Rand Corporation in the New England Journal of Medicine has many in the media aflutter with fresh pronouncements that reducing physicians’ risk of being sued doesn’t reduce defensive medicine and doesn’t save money. The study purports to show that in three states where reform was enacted certain variables, taken as indicators of defensive medicine, did not change substantially. But let’s look a little closer.

The study looked at over three million Medicare patients over the period from 1997 to 2011. Researches looked specifically at emergency room visits and measured three variables: the number of CT scans and MRIs ordered, the rate at which patients were checked into the hospital following their ER visit, and total charges for the ER visits. What they found was that in three states that changed their standard for emergency care from ordinary negligence (failure to exercise a reasonable standard of care) to gross negligence (knowingly failing to exercise a reasonable standard of care), Georgia (2005), South Carolina (2005), and Texas (2003), there was no appreciable difference in the rate of advanced imaging or inpatient check-ins, and that only in Georgia was there a very small decrease in costs. The study’s author, Dr. Daniel A. Waxman, concluded that, “This study suggests that even when the risk of being sued for malpractice decreases, the path of least resistance still may favor resource-intensive care, at least in hospital emergency departments.” But does it?

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The 6 Keys to IT Security

IT SecurityWe here at eQuoteMD had the opportunity this week to attend a HIPAA Workshop in St. Louis, Missouri sponsored by the Keane Insurance Group, Keystone IT Consulting, and the Sandberg Phoenix & Von Gontard law firm. The focus of this workshop was IT Security, specifically as it applies to the healthcare industry in light of HIPAA and other regulatory laws. While IT can seem daunting to those outside the field with all the tech talk and the ever changing technology, it’s important for doctors and/or their office managers to get a handle on what is necessary to achieve compliance. We’re now in an era where it’s simply not enough to install a firewall and a virus blocker and hope nothing happens. The rules have changed, and audits are happening with greater frequency than ever. Perhaps more importantly though, with the widespread adoption of electronic protected health information (ePHI), practices have a greater obligation than ever to ensure their patients’ privacy and the protection of their data.

In some cases this may mean getting educated yourself, but often it will also mean partnering with someone that can shepherd you through the process of becoming and remaining compliant. IT security professionals make it their business to keep up with the two moving targets that form the twin focus of IT security: public policy and technology. And it was from those two perspectives that our workshop presenter spoke as he educated us on some of the crucial elements of IT security for a medical practice.

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Top Ten Online Tools for Doctors

Top ten online tools for doctors.Today we live in a world where an online presence isn’t just recommended, it’s a given. If you have any kind of business, practice, or other public presence you already have an online presence as well. Profiles are automatically generated by review sites, online yellow pages, and even Google. So the question is not whether you will have an online presence, but whether you are leveraging the presence you already have.

We’re looking at the top ten online tools for developing your practice and managing your online reputation. Some of these are simple, one time, profile set-ups on accounts that only need to be checked in on occasionally, while others are tools that you can actively manage to better engage patients, potential patients, and the community. [Read more →]

Everybody Lies

House MD – Everyone Lies

Well, maybe not everyone, but as it turns out Dr. House’s mantra may be closer to the truth than we would hope. A recent survey conducted by EHR research group Software Advice found that a full 50% of patients surveyed admitted to at least sometimes lying to their physicians. That’s an enormous number, and it belies a real problem in doctor patient relationships. And this isn’t only a problem for morale; it’s a serious danger to both doctors and patients. If doctors are misinformed, people can end up being treated in ways that are harmful or dangerous. As the researcher responsible for the survey noted, “By not informing their physicians of all relevant medical information, both parties run the risk of misdiagnosis, the ordering of unnecessary/costly tests, and the resulting potential for medical malpractice litigation.”

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TEDMED 2014

TEDMED2014As I’m typing this, TEDMED 2014 is wrapping up. Most of us are familiar with TED, if nothing else via the occasional TED Talk that goes viral on social media. But building on TED’s tagline, “ideas worth spreading,” TEDMED describes itself as “a global community dedicated to unlocking imagination in service of health and medicine. Our goal is to seed the innovations of today, making possible the breakthroughs of tomorrow…for a healthier, more vibrant humanity.” And while TEDMED exists year round as an online community, the annual conference is what they are most well known for.

This year the conference was held simultaneously in Washington D.C. and San Francisco, with each venue hosting speakers in turn. Both Stanford and The University of California at San Francisco sponsored the event, which was simulcast not only between D.C. and San Francisco but all over the world. You can check out the talks here.

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When Can a Patient Sue? Statutes of Limitations and Statutes of Repose

Medical Malpractice Statute of Limitations – When Can a Patient Sue?While thinking about a lawsuit probably isn’t at the top of anyone’s list of things they look forward to doing, it is something that, as a doctor, you want to have a certain amount of preparedness for.  One of the things that’s important to know is, from a legal standpoint, who can and can’t bring a claim against you and when?

Basic Statute of Limitations

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Proposition 46 Making Waves in California and Nationwide

The nation is watching as money begins to pour into campaigns for, and especially against, a ballot initiative called Proposition 46 which is set to be on the November 4th ballot in California. The initiative would do three things:

  1. It would raise the caps on non-economic damages in malpractice cases from $250,000 to $1.1M.
  2. It would require doctors to submit to random drug and alcohol testing.
  3. It would require doctors to consult a state administered prescription drug database before prescribing certain drugs to first time patients.

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Why Telemedicine? What is the Future of the Virtual Appointment?

Telemedicine Benefits – Efficient Practices, Pleased DoctorsWith the recent push to achieve “meaningful use” of EHR, the advent of Accountable Care Organizations, increasing numbers of patients, and other effects of the Accountable Care Act telemedicine is becoming more common and more necessary than ever.  But what is telemedicine exactly?  The American Telemedicine Association defines it as follows:

“The use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.”

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Wisconsin Malpractice in the News

Wisconsin MalpracticeWisconsin has been in the news quite a bit lately with stories related to healthcare and particularly malpractice.  In many ways the state’s situation presents a microcosm of a number of the questions and contradictions at issue in states all across the U.S.  From debates about informed consent to available representation and fair compensation, incentives, motives and more are at issue in the many conversations being had and cases being decided across the state.  One thing is for sure—there isn’t much agreement.

For instance, malpractice filings are down dramatically in Wisconsin.  In fact, since 1999 the number of filings has dropped more than 50%.  Further, following but far exceeding a national trend, the number of paid claims in Wisconsin dropped 66% between 2003 and 2013, according to the National Practitioner Data Bank (NPDB).  These drops have followed in the wake of such reforms as the implementation of caps on non-economic damages, the creation of a state administered Injured Patients and Families Compensation Fund, and most recently passage of a law that gives doctors more discretion in the area of informed consent.

[Read more →]