Articles Posted in Medical Records

Just some quick updates on some topics that the blog has followed in recent days:

Big Soda, Big Pharma spending big to battle ballot measures

SouthDakota-StateSeal.svgSouth Dakotans will need their state lawmakers’ help now to pry open physicians’ iron grip on secret decisions about which doctors get to practice in hospitals and why. That’s because the state’s Supreme Court ruled this vital information must be kept confidential, even if releasing it would serve a wider good of disclosing possible criminal or fraudulent conduct.

The high court ducked its potential role in helping more than 30 patients who claim they were mangled in excruciating, needless surgeries performed by Allen Sossan, an osteopath with an easily discovered criminal past and a checkered medical practice record in the area around Yankton, S.D. I’ve written about this case before.

Several South Dakota hospitals gave Sossan practice privileges after his credentials were reviewed by physician committees, which, since have fought mightily to keep secret what they knew and when they knew it about him. Sossan since has been indicted for providing false information to medical licensing authorities. The convicted burglar and check kiter apparently has fled the country and may be back in his native Iran.

death-certificate-state-by-state-default-750_50California regulators have reversed themselves and decided to require hospitals to report outbreaks of “superbug” cases, rare infections that also can prove deadly. At the same time, officials in the Golden State haven’t moved to increase the information disclosed on death certificates−data that advocates suggest would give the public clearer outlines of just how severe a problem hospital-acquired infections have become.

Kudos to the Los Angeles Times, which delved in a recent front-page investigation into the dearth of information disclosed on death certificates, especially about hospital-acquired infections. The paper detailed how a Los Angeles area patient had contracted, while hospitalized, a rare carbapenem-resistant enterobacteriaceae or CRE infection. This superbug resists treatment with an array of antibiotics, eventually killing half those it afflicts. Its outbreaks are a huge concern for public health authorities.

But, The Los Angeles Times said, hospitals had cried “poor me” to the state, saying it required extensive resources to monitor and report CRE outbreaks. The death certificate for the patient with the CRE infection, the newspaper said, listed a perforated ulcer as her cause of death. Her family was outraged because they had urged Torrance Memorial Medical Center to report a CRE outbreak to the state.

WristbandAs American medicine grows ever more complex, a basic of care is getting risky short shrift: Hospitals may be failing to protect their patients’ safety by ensuring they are clearly identified and their medical records don’t get mixed up.

The Wall Street Journal provides a list of horror stories about wrong patient IDs and record mix-ups. These were detailed in a “deep dive” by the ECRI Institute, a nonprofit patient safety research group that studied more than 7,600 reported “wrong patient errors” at more than 181 health care organizations between January 2013 and July 2015. The mistakes, shared under a law that allows their reporting to federal authorities without liability, likely were only a fraction of the many more that occurred.

ECRI found that: clinicians failed to resuscitate a patient in cardiac arrest because they mistook him for another patient who had a do-not revive order in his chart; a patient who was not supposed to fed, due to a mix-up, got a meal tray and choked; an infant, confused for another, got the wrong mother’s milk and was infected with hepatitis.

prescriptionAmong the plenty of worries when an older patient has to be hospitalized, here’s one to think about:  treating physicians and their ever-ready prescription pads which put patients at risk for serious side effects that can be worse than the problem they’re treating.

Kaiser Health News has continued writer Anna Gorman’s series on the woes that elderly patients experience when hospitalized, with her latest piece giving an eyebrow-raising look, from a pharmacist’s point of view, at the prescribing practices of MDs in hospitals.

As the drug expert observes, it all is “a bit alarming.”

barcode-b4d283303a1a8ec1667da9a9cf3325b8They may seem like a cryptic pile of digits on devices that most of us might never see but will have in us, sometimes in life-saving fashion. But “unique identification numbers,” emblazoned on everything from hip implants to pacemakers, may offer a ne safety check on a burgeoning aspect of health care. They also have gotten a major boost from the federal Medicare agency.

The Wall Street Journal has reported that the agency, after years of resistance, has agreed with the federal Food and Drug Administration and patient safety advocates that the makers of medical devices should put the identifying numbers on their products, and that this information also should be recorded in patient records, particularly the new electronic versions. To be sure, this is one  step in a long regulatory process.

But experts say it could be a big advance, allowing them to better detect flawed equipment, bad processes or practices, and other situations involving medical devices and harming patients’ health and safety. Some regulators and advocates for the device makers had fought this step for some time now. They contend that it adds to costs, and it hasn’t yet demonstrated a return for the investment.

ormc_tower_00a_1024_web300x600wHere’s hoping that the mass shooting in Orlando will focus attention on some health care issues that the event flushed into open view:

bloodGay activists and others have denounced anew these restrictions. They say these rules unnecessarily stigmatize members of their community, who were bitterly reminded of them when donors sought to assist the many wounded in the Orlando gay club.

Problems with medical devices contribute to 3,000 Americans’ deaths annually, research shows, and fixing any one of the problem devices can cost hundreds of millions. So why aren’t government officials doing more and better in regulating them and protecting the public, a New York Times health policy columnist has asked.

This health economist, Austin Frakt, also has zeroed in on possible solutions, some of which have surfaced after a scandal involving diagnostic scopes used in gastroenterological procedures. Those defective and dirty scopes caused infections that have killed at least 21 and sickened dozens at hospitals nationwide, U.S. Senate investigators confirmed in January.

Experts are starting to think that medical devices each must carry distinctive numbers and tags of some kind, and that this information needs to be recorded in health records each time a device is implanted or used. Such a system exists now for medications. It has helped researchers analyze and find problems in drug prescribing.

Computerized_physician_order_entryThe United States has spent billions of dollars to try to slash medical errors, the third highest cause of death in the nation. But computerized systems that allow physicians to enter their drug orders−a key tool in the fight against one of the most common cause of medical errors−aren’t yet stopping as many problem prescriptions as they need to, says a nonprofit organization that rates hospitals’ safety.

The Leapfrog Group, with the help of outside information technology experts, surveyed 1,800 hospitals nationwide, asking them about their systems, and testing them with dummy orders for fictional patients to see if they caught errors.

The good news: 96 percent of the hospitals said they now have digitized prescription ordering systems in place, and working to some degree.

bitcoinHackers are wreaking  havoc on hospitals across the country with “ransomware” that locks up institutions’ computer systems until they pay off the miscreants. These high-profile incidents are just part of broader hacker attacks aimed at getting valuable patient information, experts say.

The latest incident targeted 10 hospitals serving hundreds of thousands of patients in the Washington, D.C. area. The hospitals were forced to cancel appointments and services, as they struggled through several days of attacks. They were reportedly limping back to normalcy.

This was one of several such incidents nationwide, in Kentucky, West Virginia, and California, and in Canada, too. A hospital in Los Angeles outraged many when it responded to a hackers’ attack that shut down its computer systems by paying a $17,000 ransom with bitcoins, a form of cyber currency. The hospital later said that tech experts, not paying the ransom, helped get the institution back to regular operations.

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