Posts made in February, 2015


Telemedicine is the remote diagnosis and treatment of patients through telecommunications technology. According to a January 2015 article in Forbes, telemedicine’s time has finally come in 2015 for the following reasons:

  • Technology has matured enough that doctors can offer patients a good experience.
  • Telemedicine technology now includes asynchronous messaging, so doctors can better utilize their time.
  • There is a greater demand among patients for the convenience of telemedicine.
  • The 60+ age group, which is not adverse to technology and has more difficulty getting to the doctor than younger patients, is expected to fully embrace the convenience of telemedicine.
  • Telemedicine will save a great deal of money and increase the value of doctors’ time by reducing the amount of time spent with patients who do not need to be seen in the doctor’s office.
  • It can keep patients engaged with their primary health care providers and their care integrated with existing health care records.

However, not everyone agrees that telemedicine is a good thing. The Texas medical board, for example, issued an emergency ruling on January 16, 2015 requiring doctors to meet personally with their patients before prescribing medications, as reported in a February 12, 2015 article in the Texas Tribune. The Tribune reports that the medical board felt these emergency measures were necessary to protect public health.

Teladoc, one of largest telemedicine companies in Texas, obtained a temporary restraining order from a Travis County judge to prevent the ruling from going into effect four days after it was issued on the basis that there was no existing imminent danger to public safety, health, or welfare. The Tribune article quotes Tara Kepler, a telemedicine attorney, as saying that all medical boards across the nation are taking similar actions, and that Texas is just a little bolder.

According to the Tribune article, Dr. Russell Thomas, an osteopath, expressed the opinion that telemedicine services pose risks for patients, particularly when drugs are prescribed. He questioned the quality of service a physician would be able to provide sight unseen, with no relationship with the patient.

The Great Plains Telehealth Resource & Assistance Center (g pTRAC) argues that telemedicine is not meant to replace existing healthcare methods, but rather intended as a tool to complement them. According to g p TRAC, e-visits are not intended for new patients or for established patients with urgent medical conditions or conditions requiring a physical examination or with significant visible components, such as a rash.

Medicaid.gov describes telemedicine as “a cost effective alternative to the more traditional face-to-face way of providing medical care . . . that states can choose to cover under Medicaid. Within certain provider and facility guidelines, Medicaid allows states the option to determine whether or not to cover telemedicine, what types of telemedicine to cover, and where and how it is provided.

The consensus of opinion appears to be that telemedicine has a number of advantages, not the least of which is the convenience and the time and money it can save. However, the question remains whether or not virtual doctors can provide the standard of care that American patients are entitled to expect from their healthcare providers.

Sources:

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Medical Errors: An Update

Medical Errors: An Update


Posted By on Feb 4, 2015

Surgical Errors Based on Wrong Medication Not Uncommon

You may have suffered a surgical error and are dealing with terrible consequences, or have lost a loved one due to a surgical error. Some surgical errors relate to instruments or sponges being left in the body after surgery, but there can be other causes. For example, administering a wrong medication or wrong dosage is also a common type of medical negligence.

How Could This Type of Error Happen?

Surgeons and other medical professionals (as well as people generally) have a tendency to see what they expect to see. This tendency even has a name – “ascertainment bias” – a form of cognitive error. A team of medical providers in a hospital setting who work together often may tend to trust each other based on prior knowledge. So, when a medication is brought to a surgeon to give to a patient, the surgeon may trust all those who handled that medication, beginning with the pharmacist and ending with the person holding the medication who hands it to him.

That expectation held by the surgeon that others can be trusted to provide the correct medication plays a role in this ascertainment bias.

A Quick Check of Medication Can Drastically Change a Patient’s Outcome

Medical malpractice errors related to giving the wrong medicine or an incorrect dosage can sometimes have terrible results. A recent tragic case in Massachusetts exemplifies the problem of a doctor having an ascertainment bias and trusting in all those who handled a medicine before him.

The surgeon looks at a drug handed over by a nurse, and is convinced that it is the right medication because it appears to be the correct medication – yet it is not. He did not read the label. The wrong medication can cause serious medical conditions, some permanent, or in many tragic cases, loss of life.

Although medical professionals must have a high level of trust in each other, every possible point at which an avoidable error is detectable should be part of standard safety protocols for surgery and all treatments involving the administration of medications. Surgeons and nurse practitioners should be required, for example, to submit detailed written prescriptions to pharmacists.

Avoidable Injuries in Hospitals at an All Time High

Medical errors are the third leading cause of death in the nation, following heart disease and cancer. Overdoses due to wrong amount of medication, or the wrong drug being administered are of great concern because these errors add to those unfortunate deaths.

A recent report estimates that 210,000 people die each year due to a preventable medical error, with the actual numbers estimated to be closer to 440,000. Serious harm to a patient is estimated to be 10 to 20 times more common than these lethal mistakes. These numbers are unnerving and are certainly cause for patients to be vigilant and proactively involved in their medical care. Sometimes simply stepping outside the norm of fully accepting all that a doctor says and does at face value and asking questions about treatment can be enough to make a doctor be more attentive. If a doctor knows he or she is being questioned, they may be more concerned about potential medical malpractice suits and therefore do their work more mindfully.

Roughly a sixth of all deaths in the USA could be attributed to a medical error, according to the report. Some disagreement exists about the numbers of deaths due to avoidable mistakes, but no one is disputing the fact that no matter what tracking system is used to measure the numbers, deaths resulting from medical errors is a serious problem.

Sources:
A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. Journal of Patient Safety
How Many Die from Medical Mistakes in U.S. Hospitals? NPR

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