Singularity Health Law Blog

DO ELECTRONIC MEDICAL RECORD INCREASE HEALTH COSTS?

It seems counterintuitive and contrary to the overwhelming majority of articles and studies, but the New York Times today reported on a study recently appearing in Health Affairs that suggested that the switch to electronic medical records resulted in a 40 percent increase in tests, most of the MRI and CAT scan variety. The study, based upon the analysis of a 2008 survey by the National Center for Health Statistics, performed for an entirely different purpose, and has questionable design.  The study followed 28,888 patient visits and 1100 physicians and claims to have a more National perspective. The authors of the study suggest that most earlier studies are based upon statistical models of expected savings like those undertaken by the RAND Corporation and the study of flagship integrated systems like Kaiser, rather than on national utilization data.

 

Comparing US And UK Head And Brain Injury Compensation Law

[This is a guest post by Joanne Berry of Pannone LLP's Serious Injury Team in the UK.]

The following article provides an overview of the US and UK legal systems regarding head and brain injuries compensation, when said injuries are sustained through accidents. To make the comparison easier, the focus of this comparison will be on head injuries or brain injuries that were caused due to a road traffic accident. The aim is to provide an interesting comparison to encourage debate and discussion of the pros and cons of both systems.

Comment on "Eight Reforms To Medical Peer Review Post."

Until my retirement three years ago I was Associate Director for Research and Disputes for HRSA's National Practitioner Data Bank.  For over 10 years I read every Secretarial Review request, assigned every case to staff reviewers, and approved every decision before forwarding it for final approval and signature by the Director.  In other words, I have great familiarity with this matter. 

Before turning to the eight suggestions, I must take issue with the implication that a report to the NPDB can destroy a career.  It is the underlying actions that hurt careers, not reports to the Data Bank.  Applications for licensure, privileges, etc., require physicians to disclose more than is required to be reported to the Data Bank.  For example, the Data Bank does not require reporting of pending cases; applications do.  Honest physicians have nothing to fear from Data Bank reports; they have to disclose the same information regardless of the Data Bank.

It also should be noted that there are thousands of physicians with multiple reports in the Data Bank who continue to practice and, often, to have even more actions taken against them and reported.  If the Data Bank ended careers, physicians would not continue to have action after action taken against them.

A COMPREHENSIVE REPUBLICAN HEALTH CARE PLAN

 To those who are struggling to understand what any of the Republican candidates embrace as to principles of health care reform other than the mantra of repeal of Obamacare: here is a Republican Plan that merits consideration.

TOP HEALTHCARE SYSTEMS

With the continuing devolution of U.S. health care into at least a three tiered class structure, we are left with a number of questions as to why the U.S. with all of its wealth and power is so far down the list of top health care systems.  It may perhaps be related to the growing transformation of the U.S. into “bananarepublichood,” where the growing gross disparity in income here leads to lack of access to care by large segments of the the population which adversely effects our overall averages in quality markers such as life expectancy and infant mortality.  When you have a combination of the best and the worst features of a health care system your average necessarily drops precipitously.

 

EMR and Cloud’s Illusions

One of often voiced concerns about the storage of medical records on the internet or in “the cloud” as it were is the fear of marauding hackers stealing information in order to exploit patient data.  Michael Koploy, and ERP analyst at Software Advoice, recently wrote an interesting post entitled “HSS Data Tells the True Story of HIPAA violations in the cloud.” His article can be reached at http://www.softwareadvice.com/articles/medical/hipaa-violations-arent-in-the-cloud-1062011/ .  He starts with the so called “Wall of Shame” at the HSS website listing the details of 281HIPAA security violations through June 9, 2011. Only seven involved EMR violations and of those only one was accessed by hacker.  The most common violation was a lost or stolen computer hard drive, often taken from a car or van. Paper records were also frequently lost or stolen to negligent inattention or poor security.  Perhaps there will be a shift toward more cases involving cloud storage attacks in the future, but at present the security fears about cloud computing seem overblown. Perhaps it would be appropriate to borrow some lyrics from Joni Mitchell.

 

                    I’ve looked at clouds from both sides now

                    From up and down, and still somehow

                    It’s clouds illusions I recall

                    I really don’t know clouds at all.

 

 

I ESCAPED FR0M A RAC [AUDIT]- A GUEST ARTICLE.

[Todays post is by Joan c. Ditges, RN, the principal in Legal Nurse Associates, Inc. a consulting company engaged in Medical Record Reviews, Summations and Analyis  and a consultant to this firm]

CMS couldn’t have chosen a more appropriate month for the initial nationwide roll out of the Recovery Audit Contractor permanent program. March is the month when many, even non sport’s fans,  are consumed by college basketball’s March Madness and find it difficult to concentrate on little else. March is the month when we begin escaping from the confines of winter as we get our first glimpses of spring only to be fooled by a late March snowstorm that seemingly blew in from no where and caught us totally unprepared. March is also the first month of the Roman Calendar and is named after Mars, the god of war. How apt that the RAC foot soldiers should wage war on our healthcare providers in March, some of who are consumed by a similar March madness in frenzied preparation for auditors, others who were lulled by the inactivity of winter and will be unprepared when the blizzard that is RAC blows into their facilities and practices.