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The Dangers of Incorporating Patient Experience of Care Data Collection Surveys in Electronic Medical Records

Posted on Mon, Jan 18, 2016
The Dangers of Incorporating Patient Experience of Care Data Collection Surveys in Electronic Medical Records

By Prash Pavagadhi
 
Through the HIPAA Privacy Rule, consumers have the right to review and obtain copies of all health information maintained by a healthcare physician, including electronic medical records (EMRs) and/or electronic health records (EHRs). The transition from paper health records to electronic medical records and/or electronic health records may expose healthcare physicians to an increased risk of liability claims, given the content collected and potential deficiencies uncovered.
 
The HIPAA Privacy Rule covers identifiable health information in both paper and digital form. The inappropriate use of EHRs and/or EHR design vulnerabilities are exposing physicians to questions on the quality of care and physician due diligence. Patients may seek online access to their digital health information if reasonably accessible. Therefore, incorporation of the physicians’ patient experience of care data collection survey results within EMRs will allow patients to obtain copies of all such data, expanding the scope of information available to patients. If patient survey data is included in the record, it establishes an expectation that the physician will review the information and act in a reasonable manner to address the patient’s stated concern.
 
Due to expanded patients’ rights under HIPAA, patients will be privy not only to the physicians’ notes and impressions and diagnostic studies, but also to the patient experience of care data, which provides physicians with the necessary feedback to re-evaluate the authorized care, timeliness of execution, and efficacy of the treatment plan. Therefore, if a patient, and, more importantly, his or her legal counsel, believes that the patient’s care was not managed consistent with the standard of care in that jurisdiction, the physician may be at risk for litigation and ensuing damages. As such, the use of the electronic medical record and/or electronic health record to store patient experience of care data collection survey results and/or electronic rounding will require physicians to assign additional resources to review each and every patient record as the data is collected and stored within the patient’s electronic medical record to ensure that any issue regarding authorized care, timely execution of care, and efficacy of care are continuously re-evaluated to avoid an adverse preventable outcome.
 
As healthcare is subjected to the ever-increasing and more complicated federal and state regulations, particularly those requiring compliance, it’s more important for physicians to ensure that patients’ healthcare records support the care that he or she authorized and is consistent with established policies and procedures related to patient care. Administrative penalties imposed by various state departments may subject physicians to substantial fines for failure to follow established policies and procedures related to patient care. Therefore, the incorporation of patient experience of care data collection survey results within electronic medical records may not only expose physicians to liability, but also to third-party fines and sanctions by state and federal agencies.
 
Given CMS’s desire to transform the patient experience by issuing penalties for poor performance to ensure physicians modify behaviors to improve patient experience as reflected by HCAHPS Patient Experience Survey results, it’s important to distinguish the data collected from the patient from the health records collected and stored within the patient’s medical record file. The collection of patient experience of care data is designed to provide physicians with valuable feedback regarding several dimensions of care, including communication with nurses, doctors and hospital staff; pain management; medicine, and discharge information, as well as the cleanliness and quietness of the hospital environment, and the overall hospital rating. This information should not be confused with the data provided by a patient to the physician via diagnostic testing, notes, impressions and observations by the physician. If the physician insists on incorporating the patient experience of care survey results within the electronic medical records and/or electronic health records, he or she must be willing to devote substantial resources to reviewing each and every entry to ensure that the authorized care is delivered in a timely and effective fashion, and, based upon the information presented by the patient within the survey, that the care plan is consistently re-evaluated and modified to address the issues raised by the patient. If physicians fail to do so, they may find themselves exposed to, at a minimum, a complaint by the patient/consumer, filings of liability/malpractice claims, and the review by both state and federal agencies to determine if the health and safety of the patient was compromised by the physician’s failure to follow established policies and procedures related to patient protection.

Prash Pavagadhi
 
Prash Pavagadhi is a leader in the field of management and marketing both nationally and internationally. He is the President and CEO of Qualitick, an organization dedicated to bringing innovative data capture, analytics, and quality improvement solutions to the market. He has worked in diverse markets in both North America and Europe, working with Fortune 500 organizations like Xerox and Eaton Corp. His insightful business and marketing strategies help organizations across numerous industries improve quality initiatives and performance. The author is also active in the community in Tampa (FL), including a Past President of the Indo-U.S. Chamber of Commerce and also served on the Board of Directors at the Museum of Science & Industry. Prash also authored, ‘The Knowledge-Power Paradigm,’ a book which explores the business strategic impact of information as a critical competitive advantage for organizations in this century.

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More Physicians Reporting Dissatisfaction With EHR Systems

Posted on Sun, Aug 16, 2015
More Physicians Reporting Dissatisfaction With EHR Systems

Compared with survey five years earlier, fewer physicians report being satisfied or very satisfied

THURSDAY, Aug. 13, 2015 (HealthDay News) -- More physicians report being dissatisfied or very dissatisfied with their electronic health record (EHR) system, compared with five years ago, according to a report published by the AmericanEHR Partners and the American Medical Association.

AmericanEHR Partners, founded by the American College of Physicians (ACP) and Cientis Technologies, surveyed physicians on use of EHRs. In a similar survey conducted five years ago, most respondents reported being satisfied or very satisfied with their EHR system (39 and 22 percent, respectively); in the current survey, 22 and 12 percent, respectively, reported being satisfied and very satisfied.

According to the report, 42 percent of respondents thought their EHR system's ability to improve efficiency was difficult or very difficult and 72 percent thought their EHR system's ability to decrease workload was difficult or very difficult. More than half of respondents (54 percent) found that their total operating costs were increased with their EHR system. Forty-three percent reported that they had yet to overcome EHR-related productivity challenges.

"While EHR systems have the promise of improving patient care and practice efficiency, we are not yet seeing those effects," Shari Erickson, M.P.H., vice president of ACP's Division of Governmental Affairs and Medical Practice, said in a statement. "We need to focus on figuring out how we can help physicians and practices to more effectively implement and use these systems."

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