Electronic Medical Records, Health Care Reform and Medical Malpractice: Hand in Hand?

In the acrimonious health care reform debate a common denominator for all participants has been the need to digitize medical records. The perceived advantages include greater access to records and the ability of physicians in different locations to communicate about patients while swiftly assaying the patients' medical chart.

These same advantages have also been enthusiastically embraced as a mechanism for reducing medical malpractice and enhancing patient outcomes. Additionally, it has been thought that electronic record-keeping will reduce medical costs overall.

Unfortunately, the reality is that errors in software, data input and a siginificant incidence of computer malfuction may have created a very expensive monster. Reports of computer glitches which resulted in children systematically being given adult doses of medicines and other problems have been reported.

After a century of paper record-keeping the transition to digital records is both time-consuming and expensive. The Washington Post explores this topic in detail and focuses on the difference between the practical reality of transitioning to electronic records and the hoped for benefits. See http://www.washingtonpost.com/wp-dyn/content/article/2009/10/24/AR2009102400967.html?hpid=topnews

This tranistion has also created a whole new species of medical malpractice claims that we, at Clark and Steinhorn are seeing. These are medical negligence cases in the District of Columbia and Maryland with both written and digital records.

Needless to say this complicates matters considerably. I suspect that it also complicates matters for health care providers and hospitals. As an avid supporter of reduced health care costs and reduced incidence of medical malpractice, I hope that this inevitable transition goes more smoothly.

Medical Device Makers: Money, Mischief, Medical Malpractice, Misgivings

As Democratic lawmakers work toward hammering out health care reform and as Republicans work to thwart them, interesting alliances form. Our favorite hometown newspaper, the Washington Post, reports one such odd alliance.

Minnesota Democratic Senators Amy Klobuchar and Al Franken are uniting with Republican Governor, Tim Pawlenty to battle concessions sought from medical device manufacturers in the proposed reform of health care. This unusual alliance stems from the prevalence of jobs in that industry in Minnesota.

President Obama and Senator Max Baucus have cajoled a variety of stakeholders in our medical system including doctors, drug companies and allied health professionals into making economic concessions to facilitate health care reform. The quid pro quo for these concessions, the influx of tens of millions of new insureds into the health care system.

Many clinics, hospitals and doctors while obliged to take Medicare and uninsured patients, can only do so with a balance of insured patrons. The proposed health care reforms contemplate compulsory health insurance for essentially the entire population.

As one can imagine, this is popular with the insurance industry (oh boy 48 million new customers) and health care providers. (oh boy insurance companies to pay us). It is not so popular with medical device manufacturers, who contend that the new insureds will not be typical users of their products. Their position is that the elderly who are already either insured by Medicare or private insurance, are the ones who need artificial hips and knees and heart stents.

They assert that there is not much room in their profitability to make economic concessions.

One must look at this assertion skeptically. The industry has been granted unwarranted protection from medical malpractice and product liability lawsuits for their defective products. The American population is aging rapidly with an ever increasing need for the industries most lucrative products.

The industry aggressively markets its highly expensive products and is thought to be a major contributor to skyrocketing medical care costs. It is also a major contributor to political candidates in a position to help them.

The politicians are in a bit of a pickle. The jobs in medical device manufacturing and sales are good ones in a time of
recession. At the same time,  long-term concessions from the industry could go a long way toward making health care reform possible.