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Risk Matters: 2022 Risk Wrap Up

November 2022  |  Jeffrey A. Woods, JD

Most loyal readers of the Sentinel are familiar with the Risk Education department because of the monthly “Risk Matters” column.  You may also know the department as the arm of your company that produces live seminars and develops many of our online courses.  However, some of you may not...

Risk Matters: Requirements for Patient Accessing and Posting Results

October 2022  |  Jeffrey A. Woods, JD

Practices should be familiar with the general requirements of the HHS ONC Cures Act Final Rule, also known as the ONC Information Blocking Rule, which became effective in 2021. Among other aspects of compliance with the regulation, practices should have documented procedures that outline how both in-house and...

Risk Matters: Supervision and Delegation of Advanced Practice Providers

September 2022  |  Jeffrey A. Woods, JD

A topic which generates many questions from policyholders is the supervision of and delegation to advanced practice providers. The questions we are asked most frequently are: “What is the liability risk to the supervising/collaborating physician?” “What are the duties of the supervising/...

Avoid Using Disclaimers for Dictation, Voice Recognition Software, Electronic Health Records

August 2022  |  Jeffrey A. Woods, JD

Providers are legally accountable for the accuracy of the information in their notes, and personal review of entries in a timely fashion provides the opportunity to make any needed corrections. All notes and medical record entries should be reviewed for accuracy and properly authenticated (signed) by the prov...

Risk Matters: Tracking Procedures

July 2022  |  Jeffrey A. Woods, JD

Missed diagnosis is a top claim received at SVMIC.  The tracking of lab and diagnostic test results, as well as referred patients and missed or canceled appointments, is essential to avoid delays in diagnosis and/or treatment. A patient may fall through the cracks if an abnormal test result is misplaced ...

Risk Matters: Chaperones

June 2022  |  Jeffrey A. Woods, JD

There are often many questions regarding the use of a chaperone such as who, when, why, what (if the patient refuses/is the chaperones role) and how often? This article will attempt to answer these questions by examining the recommendations of SVMIC and the AMA. In the current environment, it is important tha...

Tracking Referrals & Consultations

May 2022  |  Jeffrey A. Woods, JD

A frequently asked question when referrals are made is, “What is my duty as the referring physician to ensure that the patient keeps his/her appointment with the consultant?”  Many physicians do a good job of tracking labs and diagnostic tests, but they do not think about tracking appointment...

Sample Medication Management

April 2022  |  Jeffrey A. Woods, JD

It is common practice for physicians and providers to dispense free sample medications to patients. The benefits of dispensing sample medications are numerous:  it allows patients to try new medications on a trial basis; saves patients money on expensive medications; reduces non-adherence to medicat...

Risk Matters: Physician Health and Well-being

March 2022  |  Jeffrey A. Woods, JD

 “Everybody perceives stress in different ways… and there's not one blanket way of handling stress.  But, the most important thing is to understand that you are stressed and recognize how it manifests in you. Some people clench their teeth, some tighten their shoulders, some have GI ups...

Risk Matters: New Course on Litigation

February 2022  |  Jeffrey A. Woods, JD

A wise attorney once told me, “The road to serenity is not paved with litigation.” How true that is. Unfortunately, litigation is a familiar experience for those of us who practice medicine -- most of us will find our serenity traumatized by a lawsuit during our career. The stress can be overwhelm...

Risk Matters: COVID-19 Vaccines

January 2022  |  Jeffrey A. Woods, JD

Ever since the U.S. Food and Drug Administration (FDA) authorized the emergency use of specific formulation (10 mcg/0.2 ml) of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine for children ages 5 through 11 years, reports of mix-ups with the Pfizer-BioNTech COVID-19 vaccine formulation intended...

Risk Matters: What to Keep Out of the Medical Record

November 2021  |  Jeffrey A. Woods, JD

At SVMIC, we stress the importance of accurate and timely documentation and for good reason – in the event of a claim or lawsuit, the medical record will be the most important piece of physical evidence.  But, just as important as what to include in the medical record is what not to include. Only ...

Risk Matters: Remind Your Patients to Get Their Flu Vaccine

October 2021  |  Jeffrey A. Woods, JD

With the emphasis on COVID-19 vaccines and boosters, many patients may forget another respiratory virus that presents a significant health risk – influenza.  It is important you educate your patients on the need to be protected from this potentially fatal virus, especially your patients who are 65 ...

Risk Matters: Telephone Calls

September 2021  |  Jeffrey A. Woods, JD

Documenting telephone encounters should be treated with the same level of importance as documenting in-person visits. Telephone conversations, particularly those that occur after-hours, are a major area of liability risk. The advice given to a patient over the telephone often becomes crucial to his or her con...

Risk Matters: EHR Duplication

August 2021  |  Jeffrey A. Woods, JD

EHR Duplication:  Native Form vs. Printed Copy Physicians’ offices receive a large number of requests for copies of medical records from patients, their representatives, insurance carriers, attorneys, and other providers.  Prior to the advent of electronic health records, someone in the offic...

Risk Matters: EHR Tips

July 2021  |  Jeffrey A. Woods, JD

Every EHR system has an audit trail. The timeline is no longer a guessing game. Gone are the days of using handwriting experts to try to determine when and by whom an entry was made in a patient’s chart. Forensic IT experts can now review the metadata contained within the EHR to determine everything tha...

Risk Matters: Wrong-Site, Wrong-Procedure, and Wrong-Patient Surgery

June 2021  |  Jeffrey A. Woods, JD

Few medical errors are as indefensible as those involving patients who have undergone surgery on the wrong body part, undergone the incorrect procedure, or had a procedure performed that was intended for another patient. These “wrong-site, wrong-procedure, wrong-patient errors” (WSPEs) are termed ...

Risk Matters: Unsolicited Test Reports

May 2021  |  Jeffrey A. Woods, JD

When an unsolicited test result is received regarding an established patient of the practice, it should be handled the same way as one that was personally ordered. Contact the patient, notify the ordering physician, and, if appropriate, arrange for needed follow-up care. Do not automatically assume normal res...

Risk Matters: Informed Consent

April 2021  |  Jeffrey A. Woods, JD

Last month, we discussed the importance of the informed consent discussion to prevent malpractice claims.  As a follow-up, remember that it is the discussion that takes place between the provider and the patient (or patient’s legal representative) that constitutes the basis for the consent to be &l...

Risk Matters: Informed Consent

March 2021  |  Jeffrey A. Woods, JD

Informed consent is often the most important discussion that physicians will have with their patients, but unfortunately, it is sometimes viewed as merely obtaining a signature on a pre-printed form.  While lack of informed consent is rarely the central issue in a malpractice lawsuit, it is almost always...

Risk Matters: Telemedicine

February 2021  |  Jeffrey A. Woods, JD

Governmental shelter-in-place orders and the need to avoid unnecessary physical contact driven by the coronavirus pandemic have caused many providers and patients to suddenly turn to the virtual world to provide and receive care.  While this has generally been good for the healthcare system and patient s...

Risk Matters: Telemedicine

January 2021  |  Jeffrey A. Woods, JD

When practicing telemedicine, keep in mind that the medical services are being rendered at the patient’s location.  Therefore, the provider must:  be licensed in the state where the patient is located; be familiar with the standard of care in the patient’s location and comply with th...

Contemporaneous Documentation

October 2018  |  Julie Loomis, RN, JD

An old Chinese proverb says that “the faintest ink is more powerful than the strongest memory.” Timely documentation is critical in order to ensure an accurate and complete record of the patient encounter. Office notes and dictated procedure notes should be completed, reviewed and signed within 2...

Informed Refusal

September 2018  |  Julie Loomis, RN, JD

Physicians and other clinicians are well aware of the legal obligation to provide informed consent for treatment. A fundamental component of consent is providing the patient with sufficient information to make an informed decision about the risks, benefits, and alternatives of the proposed treatment. Clearly,...

Best Practices for Handling Missed Appointments

August 2018  |  Julie Loomis, RN, JD

Medical practices are often challenged with how to handle a missed appointment during which follow-up care or treatment was to be provided. It is important that the practice have a procedure to ensure that no-shows and cancellations are communicated to the treating provider and any actions taken are documente...

ECRI Institute Reveals Top 10 Patient Safety Concerns of 2018

July 2018  |  Julie Loomis, RN, JD

Each year, ECRI Institute – a nonprofit organization that researches approaches to improving patient care – identifies TOP 10 Patient Safety Concerns. This list identifies key areas to “support health care organizations in their efforts to proactively identify and respond to threats to ...

Unsolicited Test Results

June 2018  |  Julie Loomis, RN, JD

From time to time, physicians and other healthcare providers find themselves in receipt of diagnostic test results they did not order for their patient, or for individuals who are not even patients of the practice at all.   Such results could be anything from laboratory or pathology reports to scree...

Making the Most of Team Meetings

May 2018  |  Julie Loomis, RN, JD

Like most busy physicians, you probably dread the monthly team meeting to take a closer look at office processes and systems. In a day filled with playing phone tag, wading through e-mails, dealing with unexpected patient situations, following up on tasks and documenting, where’s the time to squeez...

Turning a Negative into a Positive: Managing Patient Complaints

April 2018  |  Julie Loomis, RN, JD

Increasing concerns about the quality of healthcare have arisen as a result of the public perception that cost-cutting measures have caused premature discharge and clinical mismanagement of patients. Changes in healthcare coverage have generated concerns that medical care has become a profit-motivated busines...

Avoid Drifting into Unsafe Habits

March 2018  |  Julie Loomis, RN, JD

Have you or your staff been “drifting into unsafe habits?” Do you follow the template generated by your EHR without questioning its validity or applicability to the patient in front of you? Do you ignore alerts and other prompts? Do you ask only close-ended questions of patients such as, “Ar...

The Patient Experience

February 2018  |  Stephen A. Dickens, JD, FACMPE

As healthcare evolves, so do patients’ expectations. Payers are changing reimbursement strategies to focus on value-based care, therefore patients' experiences and subsequent reviews of those experiences can affect the practice’s level of reimbursement. Understanding patients’ opinions and e...

Distractions in the Workplace

January 2018  |  Julie Loomis, RN, JD

Distractions and interruptions are a fact of life in today’s healthcare environment, but that doesn’t mean a practice should simply accept them and the threat they pose to patient safety. Identifying the sources and frequency of distractions and interruptions allows for implementation of strategie...

It Takes a Village

November 2017  |  Julie Loomis, RN, JD

Electronic Health Records offer the potential for vast improvement in continuity of care, legibility and accurate recordkeeping. However, to most practitioners, that goal seems light years away. This is due to many factors out of the user’s control such as technology, design and integration issues. The ...

It's Not Too Late to Vaccinate

October 2017  |  Julie Loomis, RN, JD

Last month, the CDC issued a letter to healthcare providers asking for help to ensure patients receive influenza vaccines by the end of October. The letter states “…To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizat...

Jousting

September 2017  |  Julie Loomis, RN, JD

The adage about “people who live in glass houses” still holds true. Jousting usually occurs when another healthcare professional intentionally or unintentionally either verbally or in the medical record makes disparaging comments about other providers, nursing staff, equipment, EHR or administrat...

Patient Portals

August 2017  |  Julie Loomis, RN, JD

At SVMIC, we’re often asked if a practitioner can utilize the patient portal to notify patients of lab/test results that are normal and require no follow-up. The short answer is yes, you can use your patient portal to communicate lab/test results that are normal, require no immediate attention and are n...

Risk Pearls: July 2017

July 2017  |  Justin Joy, JD, CIPP

Tempting as it may be, think twice before accessing medical records if you receive a notice of intent to sue or are served with a lawsuit. An electronic health record (EHR) system tracks activities and records the information in metadata—the “data about data”—o...

Memphis Maxims

June 2017  |  Hugh Francis III, MD

At the UT College of Medicine, rising third-year medical students usually begin their clinical rotations during the first week of May.  In preparation, UT has historically educated these students in risk management, where they learn, among many other things, the importance of their patients’ knowin...

Risk Pearls: May 2017

May 2017  |  Julie Loomis, RN, JD

Do you have a procedure for handling a missed appointment during which follow-up care or treatment was to be provided? To avoid patient harm and a claim of missed or delayed diagnosis, it is important that practices have a procedure to ensure that no-shows and cancellations are communicated to the treating pr...

Risk Pearls: April 2017

April 2017  |  Julie Loomis, RN, JD

Spring has sprung, which means spring cleaning for many of us. It may also be a good time to retool your office tracking procedures, as diagnostic error accounts for one-third of SVMIC’s paid claims. Tracking system failures are a primary factor in diagnostic error. Maintaining a system within each offi...

Risk Pearls: March 2017

March 2017  |  Julie Loomis, RN, JD

One of the simplest tools for improving your communication with patients is intentional or "active" listening. When a new mother brings her baby to the office, listening to her description of the problem often provides that subtle clue a physical examination may not have revealed. Not all medical interactions...

Risk Pearls: February 2017

February 2017  |  Julie Loomis, RN, JD

According to the Food and Drug Administration (FDA), it regulates one trillion dollars’ worth of products each year or approximately 20 cents on every dollar spent in the U.S. When there is a serious problem with a product, the FDA would like to alert you immediately. The alerts contain actionable infor...

Risk Pearls: January 2017

January 2017  |  Julie Loomis, RN, JD

The term “culture” in your medical practice shouldn’t only mean a lab test to identify microorganisms. Even if you’re not aware of it, there is an environmental culture within your practice that affects productivity, staff performance and patient safety. Culture is a system of shared v...

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