malpractice

RECENT POSTS

Mass. Study: Electronic Health Records Bring 6-Fold Cut In Malpractice Claims

A sample electronic medical record (Wikimedia Commons)

There’s strong consensus that the American medical system must march decisively into the era of electronic health records and the shift is happening rapidly, particularly here in Massachusetts.

But understandably, some concerns remain that computer glitches could potentially cause errors. I don’t even like to imagine a doctor with my technological abilities — or lack thereof — getting used to a new prescription or diagnostic system. So here’s a bit of reassuring news from a paper just out online in the Archives of Internal Medicine:

“The rate of medical malpractice claims when electronic health records (EHRs) were used appeared to be about one-sixth the rate when EHRs were not used, according to a research letter that reported on a total of 51 unique closed malpractice claims and survey data from some Massachusetts physicians.”

From the paper, some interesting analysis on whether this really means better medicine is being practiced:

This study adds to the literature suggesting that EHRs have the potential to improve patient safety and supports the conclusions of our prior work, which showed a lower risk of paid claims among physicians using EHRs. By examining all closed claims, rather than only those for which a payment was made, our findings suggest that a reduction in errors is likely responsible for at least a component of this association, since the absolute rate of claims was lower post-EHR adoption. Continue reading

NEJM: Malpractice Reform Heads In New Directions, Because It Has To

Gov. Deval Patrick


Gov. Patrick’s plan for the next wave of health reform includes changes in malpractice rules. To quote our own Bob Oakes:

Under proposed changes, doctors in Massachusetts would be able to apologize to patients — without the risk that their apology could be used against them later, in court. The state would also implement a six-month “cooling off period,” so that hospitals and patients could try to resolve problems without lawsuits.

An article just out in the New England Journal of Medicine offers some enlightening background on the current state of thinking on malpractice reform. Written by two Harvard experts, Allen Kachalia and Michelle M. Mello, it describes a pivotal moment that I’d sum up thusly: Most of what we’ve tried so far hasn’t worked very well. Let’s try some new things.

The authors write:

Medical liability reform is headed in a new direction, reflecting dissatisfaction with both the narrow focus of traditional approaches to liability cost control and the lack of effectiveness of most traditional reforms in achieving even that limited objective. The launching of the federal demonstration projects may reduce the impetus for federal statutory reform in the immediate future, but it may reap longer-term gains. By spurring both private innovation and nontraditional public-policy reforms, the new approaches to medical-injury response that are now being tested may bring us closer to a liability system that fosters, rather than obstructs, progress toward safe and high-quality health care.

And they note some clearly good news: research on the effectiveness of various malpractice reforms has expanded and improved in recent years.

Malpractice Lessons For Mass. From Michigan: Safer Doctors Mean Safer Patients

WBUR host Bob Oakes


WBUR’s Morning Edition host Bob Oakes reports here:

BOSTON — One plank of Gov. Deval Patrick’s plan to bring down soaring health care costs in Massachusetts is to change the laws around medical malpractice.

Under proposed changes, doctors in Massachusetts would be able to apologize to patients — without the risk that their apology could be used against them later, in court. The state would also implement a six-month “cooling off period,” so that hospitals and patients could try to resolve problems without lawsuits.

Rick Boothman, the chief risk officer at the University of Michigan health system, uses some of the ideas that Patrick is proposing. If his hospital makes a mistake, they tell the family they’re at fault and apologize — without the condition that the family won’t sue.

Boothman told Bob on the air today that the Michigan approach has dramatically cut the number of malpractice claims, as well as the number of those claims that end up in court. And it has changed medical culture, too.

“In order to make patients safer, we have to make doctors safer,” he said. “This is the only profession I know where it’s inherently risky to begin with, and a mistake can ruin someone financially. That’s unfair.”

“We tell our staff that they must always feel free to express sympathy and empathy to a family,” apart from any apology, he said. And as for apologies, “We not only say ‘I’m sorry it happened,’ but ‘I’m sorry we did this.’”

“We have to find a way to keep physicians and nurses professionally accountable,” Boothman said, “but we have to make the system far less punitive.”

Daily Rounds: Legal Challenges To Reform; Brokers Thrive; Baker’s Record; Cautionary Malpractice Tale

Healthcare lawsuit: States opposed to healthcare overhaul pin hopes on Florida court hearing – latimes.com Conservative legal challenge to federal reform comes to court this week. (Los Angeles Times)

Patient Money – Health Insurance Brokers Can Guide Individual Buyers – NYTimes.com Brokers are busier than ever as individuals explore their new options. (The New York Times)

A brash change-agent, Baker rose fast – The Boston Globe [Gubernatorial candidate Charlie] Baker “made a variety of radical moves in state government. Some would come back to haunt him, including his decision to approve the hospital merger that created Partners HealthCare, the powerful consortium some blame for helping push up health care costs.” (Boston Globe)

Yale Alumni Magazine: Light & Verity Surgeon told patient ‘We got it all’ when in fact she never had cancer and he knew it. $12 million and 15 years of legal proceedings later, she says she might not have sued if doctors had been honest and apologized. (yalealumnimagazine.com)