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EHR and Malpractice Lawsuits

Posted on January 23, 2013 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Long time reader Carl recently pointed me to this excellent AHIMA article on EHR and Malpractice Lawsuits. It’s first section sums up the current state of EHR and lawsuits quite well:

Medical records are a vital part of any healthcare lawsuit because they document what happened during treatment. Paper medical records are relatively simple aspects of litigation. HIM staff pull the requested chart, track down additional information as necessary, and sometimes provide a deposition on the record’s accuracy.

The process is far more complex with an EHR. The record of a patient’s care that a clinician views on screen may not exist in that form anywhere else. When the information is taken out of the system and submitted into legal proceedings, the court has a very different view—one that often confuses the proceedings and, in the worst instances, raises suspicions about the record’s validity.

The challenges stem from the design of the systems, which were built for care—not court. If the provider struggles in providing documentation, a trial involving malpractice can easily shift its focus from an examination of care to a fault-finding mission with the recordkeeping system. At other times, the provider’s inability to put forward the information in a comprehensible format may raise suspicions that it is missing, withholding, or obscuring information.

I’d probably modify the sentence that says that EHR’s were “built for care-not court” to say that EHR’s were “built for billing-not court”, but the idea is still the same. The big issues for EHR in lawsuits is that there’s no really good precedent for how an EHR will be treated in court. We’re so early in the process of legal cases that use EHR documentation, that we just don’t know how the courts are going to deal with EHR documentation.

Plus, when you consider that there are 300+ EHR companies out there, I’m not sure that a legal case with one EHR software is going to be applied the same way to the other EHR software. Each EHR displays data differently. Each EHR audits users differently. Each EHR stores data differently. So, I expect that each EHR will be looked at in a different way.

The AHIMA article linked above is a good read for those interested in this topic and points out a lot of other issues that could face an HIM staff that’s dealing with a case involving documentation in an EHR. Although, one of the overriding messages is that HIM staff and healthcare organizations are going to need an expert of their EHR involved in the process. In fact, I can see many HIM departments getting trained up on EHR in order to fulfill this need.

What I also see coming is a new group of EHR expert witnesses. Again, I think that these expert witnesses will have to have specific knowledge of a particular EHR to be really effective. I’m sure they’ll come from the ranks of EHR consultants, former EHR employees, and some EHR users. Considering the millions of dollars on the line in these malpractice cases, these EHR expert witnesses stand to make a lot of money.

I don’t want to make it all sound doom and gloom. I expect that there will be many cases involving EHR where a doctor or institution is covered better by an EHR than they were in the paper world. This will be even more true as EHR vendors continue to shore up their EHR audit logs and processes. There’s new legal risks with EHR, but there are also old risks that are removed by using an EHR. We just need to make sure we’re ready for the new risks.

CDC Releases Influenza App

Posted on I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Flu season is in full swing, and if the amount of news articles I’ve read about it is any indicator of how serious it has been, I’m surprised no one I know has gotten it yet. In an attempt to help educate people about what’s going on, and how to prevent getting the flu themselves, the CDC launched an app totally dedicated to it. It’s name is plain and simple — CDC Influenza. 

It seems as if the CDC is getting rather tech-savvy, with the recent release of their new mobile app. And apparently, the CDC feels that the influenza outbreak this year is serious enough to warrant it’s own mobile app. Unfortunately, unlike the CDC app, it’s only available for iOS devices, so anyone with an Android phone or tablet is out of luck. Luckily, my husband and I just purchased an iPad mini, so I can actually review it.

Before I downloaded it, I saw this article about the app. It talks about the mixed reviews of the app, but how it is overall helpful. I found myself feeling the same way as I browsed through the options. Here is the menu, and what the app has to offer:

Overall, I found everything to be very information-heavy. I found pages of information that I didn’t really want to read. There are a lot of different sections though, so anyone that is interested in the flu might find it useful. I think it’s good that the app includes information about the vaccination and the safety of it, because I know that’s an issue of concern with a lot of people.

I did like that there was a map which showed where the flu was, and how widespread it was. As you can see below, it’s pretty much everywhere. That’s enough to make me want to coop up inside until Spring!

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The app seemed a little bit slow and jumpy to me. It seemed like every few minutes, a box that says “Updating Content…” would pop up, and for the next few minutes, the app was unusable. I’m not sure why that happened — perhaps there is just a lot of important updates?

This definitely seems more like an app for physicians to download. I think it’s probably important for them to be informed about the current situation and be able to access this information while visiting with patients. I could imagine our physician using this app on his tablet to answer questions. For just anyone though, I think this isn’t the most user-friendly app, as it’s more just informative, unless the person is really interested in learning about influenza.