Rhode Island EM docs under investigation

[miacomet]

Well, that's going to improve physician satisfaction:

Medscape: Medscape Access

FWIW, RI is a terrible place to practice medicine.

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[namethatsmell]

This is insane.

Yes, let's go after docs who self-report. That will create a wonderful culture.

I have a radical idea to keep the health department trolls occupied while actually providing a useful service to the public: investigate and censure insurance companies who deny payment for reasonable (a priori) ED visits.

 

[southerndoc]

Can't access the article. I deleted my Medscape account because of the endless spam they send.

 

[thegenius]

Me neither.

 

[GonnaBeADoc2222]

I think the link is fixed now.

How disgusting. I'm sure if the docs in question weren't having 18 EKGs thrown in front of their face and every nurse/tech in the department wasn't telling them about how the patient in 14 has 10/10 pain and how the patient's brother in 17 just showed up and "wants an update" this stuff wouldn't happen.

 

[thegenius]

Nope...still a login for me. can you copy/paste the article? or will that lead to lawyers wanting your money?

 

[NYEMMED]

So why self report now. Motto of what Rhode Island wants “hide everything”.

This is going to jeopardize medical care

 

[Birdstrike]

It's a terrible thing to punish a doctor for self reporting, for sure.

There's a lot not specified in this article, though. If the EHR is messed up and changing people's correct orders to incorrect orders (doubtful) then the docs will be cleared easily in the end. It still sucks to be investigated. I personally had to fight an idiotic board investigation because someone else's imaging study got my name put on it in error, as the ordering physician. After 7 months, talking to lawyers, composing a tome-like packet of annotated records proving my innocence, I was cleared 100%. But it sucked, man it sucked. In fact, it cut closer to my core than any malpractice accusation ever could, because board actions don't involved people trying to get your insurance company's money. It involves people trying to destroy your career and life, without wanting a penny from your. It's much more jarring, in my opinion.

If, on the other hand each case has it's own individual cause and explanation, then the answers as to how justified each complaint are, are as numerous as the number of complaints. One may not have anything to do with the other. That's a much tougher thing to judge from a short article.

Bottom line: There's a lot of baggage that goes with playing in the Big Leagues. Add this to the list. Whether it's worth it or not, is a different thread, so I won't derail.

 

[deleted109597]

For those without medscape.

Four emergency department (ED) physicians at Rhode Island Hospital in Providence recently received subpoenas in connection with tests they had mistakenly ordered, according to Politico. This report raises disturbing questions about whether physicians can safely report their errors, even if those mistakes result from the design of their electronic health records (EHR) system, observers say.

Politico reports that the physicians received the subpoenas after ordering scans on the wrong sides of three patients and for one wrong patient. Upon discovering their errors, which may have been due to EHR system issues, they reported them. Clinicians are legally required to report wrong-site and wrong-patient issues to the Rhode Island Department of Health (DOH), department spokesman Joseph Wendelken told Medscape Medical News.

Wendelken said that DOH itself did not serve any subpoenas on ED physicians at Rhode Island Hospital. "However, that doesn't mean that investigations are not underway," he noted. Asked about Politico's allegation that DOH plans to hold a hearing on the physicians' actions, he said, "I cannot comment on active investigations. However, hearings are sometimes a part of the investigatory process."

In a statement provided to Medscape Medical News, Wendelken said that DOH is legally required to conduct investigations when hospitals fail to identify patients accurately or conduct wrong-site procedures. "These investigations are done by impartial professional boards that thoroughly review all of the relevant facts and make decisions that are in the interest of the public's health and safety," he stated.


The physicians who allegedly received the subpoenas for the improper scans have not been identified. Politico quoted one of their colleagues as saying that the subpoena charged that the physicians' errors constituted "incompetent, negligent, or willful misconduct" and that the tests were "medically unnecessary."

Rhode Island Hospital has been under a state consent decree since last June, according to the Providence Journal, because of three mistakenly ordered radiological tests and a procedure performed on the wrong section of a patient's spine. To avoid regulatory action, the hospital pledged to spend at least $1 million to implement system improvement measures.

Most states require hospitals to notify their health departments about "sentinel" safety events such as a death or loss of limb that resulted from a medical error, said Lorraine B. Possanza, DPM, program director of the Partnership for Health IT Patient Safety at the ECRI Institute in Plymouth Meeting, Pennsylvania. However, she told Medscape Medical News, it's not clear that ordering a wrong-side or a wrong-person scan rises to the level of a sentinel event if it didn't cause patient harm.

Nevertheless, Wendelken said, the state requires all wrong-site procedures and identification events to be reported to the health department "because a healthcare professional 'order' starts a series of events that may involve medication, a lab test, a diagnostic test, or an invasive procedure. Patients in Rhode Island need to be confident that when they enter a licensed facility, every medication, lab test, diagnostic study, or procedure was intended for them. Our patients expect and deserve safe and reliable care."

Also available here. Physicians subpoenaed in Rhode Island, allegedly after reporting EHR risks

 

[WilcoWorld]

After reading McNinja's link (thanks for that), it seems like we may be reacting to something other than what actually happened.

"Four emergency department (ED) physicians at Rhode Island Hospital in Providence recently received subpoenas"

Getting a subpoena =/= being charged with something. It means that you're commanded to answer questions about something.

 

[Arcan57]

After reading McNinja's link (thanks for that), it seems like we may be reacting to something other than what actually happened.

"Four emergency department (ED) physicians at Rhode Island Hospital in Providence recently received subpoenas"

Getting a subpoena =/= being charged with something. It means that you're commanded to answer questions about something.

I think we can all agree that getting subpoenaed is an undesirable outcome for reporting EHR issues.

 

[WilcoWorld]

I think we can all agree that getting subpoenaed is an undesirable outcome for reporting EHR issues.

Yeah, it's a pain in the ass. I'd rather get a follow-up call than a subpoena.

But it's misleading to go from docs being subpoenaed to saying "Rhode Island EM docs under investigation."