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Kludgey Electronic Health Records Are Becoming Fodder For Malpractice Suits
Lucas123 writes The inherent issues that come with highly complex and kludgey electronic medical records — and for the healthcare professionals required to use them — hasn't been lost on lawyers, who see the potential for millions of dollars in judgments for plaintiffs suing for medical negligence or malpractice. Work flows that require a dozen or more mouse clicks to input even basic patient information has prompted healthcare workers to seek short cuts, such as cutting and pasting from previous visits, a practice that can also include the duplication of old vital sign data, or other critical information, such as a patient's age. While the malpractice suits have to date focused on care providers, they'll soon target EMR vendors, according to Keith Klein, a medical doctor and professor of medicine at UCLA. Klein has been called as an expert witness for more than 350 state or federal medical malpractice cases and he's seen a marked rise in plaintiff attorney's using EMRs as evidence that healthcare workers fell short of their responsibility for proper care. In one such case, a judge awarded more than $7.5 million when a patient suffered permanent kidney damage, and even though physicians hadn't neglected the patient, the complexity of the EMR was responsible for them missing uric kidney stone. The EMR was ore than 3,000 pages in length and included massive amounts of duplicated information, something that's not uncommon.
As someone who works for another government agency and has to read their records regularly... Their records are some of the most duplicative and annoying to read out of all EMRs. They frequently list medications a patient took a decade ago! They dump basically every single bit of medical evidence into every visit. Frequently every visit has uncompleted screenings for depression, PTSD, and alcohol abuse. There are other programs that are worse, but the VAs records are awful.
We've noticed the copy-pasting, btw. Handwritten records were harder to read, but easier for us to interpret since we didn't need to ponder if this was current medical information or historical. EMRs blur that line.
I've personally had a physician mess up at least twice in my own care thanks to EMR...once because they thought I had an thyroid condition just because my last blood panel included a TSH, and once because they had copy-pasted a different PATIENT's prescription list in and tried to prescribe something I would have had an interaction with... EMRs are dangerous in the hands of lazy doctors, and having seen most of the programs available and their output, a lot of it is because of lazy programming that makes simple tasks difficult. For example...handwritten records? No comment meant no issue. How many programs expect an answer for every category. Doctors get lazy. They click everything. Then you have no idea if somebody did or did not have an usual neurological finding, etc... Classic case of too much information being copied from prior records and too little coordination between software developers and physicians (and other people who read medical records).
That's an ICD-10 code, and the Feds don't generate them, WHO does.
If anything, codes like that standardize care, reporting, and billing. This way, two systems that are otherwise incompatible can have the following conversation:
What was the cause of injury? Sucked into an airplane engine
What treatment did the patient receive? (insert set of ICD codes for treatment)
Insurance company pays rates based off the ICD codes, done.
There's 68,000+ codes in ICD-10. There's going to be a few odd ones in there.