EHR, Telemedicine, and E-risk

Professional Education
Physical Examination and Its Impact on Outcomes
The Doctor's Advocate
Advancements in technology improve the timeliness and accuracy of many diagnoses but the technology does not replace a thorough physical examination. For some diseases, such as Parkinson’s disease, herpes zoster, cellulitis, and Bell’s palsy the PE is the only diagnostic tool available. This short course makes the case for reversing the downward trend for physical examinations.
0.75 Credits

Professional Education
Psychiatry: Preventing Adverse Outcomes
The Doctors Company study of closed claims reveals areas of higher risk in outpatient psychiatry practices. Using this as a foundation, the course provides information to evaluate your practice and make changes to improve decisions about treatment, operational processes, reporting, and documentation.
1.5 Credits

Feb 27, 2019
Wearable Medical Devices Give Abundant Data—and Risks
Miranda Felde, MHA, CPHRM, Vice President, Patient Safety and Risk Management
The number of US consumers tracking their health data with wearables has doubled. And that number continues to rise. Wearables bring promise, but also real risks for patient safety and physician liability.

Feb 08, 2019
Cybersecurity and Data Breaches Report
It’s not a matter of if a data breach will occur in your medical practice—it’s a matter of when. Make sure your practice is prepared with this guide, which covers how to comply with HIPAA rules in the event of a breach, how to thwart ransomware attacks, how to combat password theft, and more.

Dec 01, 2018
Survey: Doctors Conflicted but Patients Still Top Concern
Bill Fleming, Chief Operating Officer
The Future of Healthcare Survey revealed a complicated picture about the attitudes of physicians towards the state of healthcare.

Professional Education
Medical Office Assessments Reveal Hidden Liabilities
The Doctor's Advocate
The Doctors Company’s patient safety risk managers conducted office practice assessments across a range of practice environments around the country. This activity analyzes the results, highlights problem-prone areas, and offers strategies to minimize areas where patients can “fall through the cracks” and leave the practice vulnerable to a malpractice claim.
1.0 Credit

Sep 17, 2018
Ransomware Attack Options: Restore, Pay, or Lose Patient Data
Craig Musgrave, Senior Vice President, Information Technology
Ransomware is an attack where a business or individual’s computer system is held hostage by cybercriminals until a ransom is paid. Hospitals, medical practices, and businesses should take full precautions to prevent a hack that results in ransomware being installed.

Jul 27, 2018
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager II
Digital distraction in healthcare is emerging as a great threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.

Video Jul 27, 2018
Malpractice Repercussions: Distracting Devices and Patient-Centered Care
The health environment has been invaded by not only medical technology, but by individuals who become too connected to their own devices. Steven Weintraub, MD, interviews Peter J. Papadakos, MD, FCCM, FAARC, about distracting devices in the context of patient-centered care and the malpractice repercussions that occur when practitioners appear to be distracted.

Video Jul 27, 2018
Addiction Indicators: Distracting Devices and Patient-Centered Care
The health environment has been invaded by not only medical technology, but by individuals who become too connected to their own devices. Steven Weintraub, MD, interviews Peter J. Papadakos, MD, FCCM, FAARC, about the potential for a physician to be perceived as addicted to a personal electronic device.

Video Jul 27, 2018
The Stress Paradigm: Distracting Devices and Patient-Centered Care
The health environment has been invaded by not only medical technology, but by individuals who become too connected to their own devices. Steven Weintraub, MD, interviews Peter J. Papadakos, MD, FCCM, FAARC, on distracting devices and how they contribute to physician stress.

Professional Education
Distracted Practice Reduction: Strategies for Healthcare Leaders
Healthcare leaders play an important role in patient safety. This activity examines how distraction and interruptions impact safe patient care and identifies what leaders of organizations, teams, and departments can do to address the problem.
1.25 Credit

Jun 26, 2018
Remote Patient Monitoring: Handling Real-Time Data
Susan Shepard, MSN, RN, Director, Patient Safety Education
Remote medical devices allow healthcare providers to closely monitor patients outside of the office, which can help improve patient health and contain healthcare costs. This article outlines the liability risks doctors face with using remote devices to monitor patients.

Jun 12, 2018
Digital Medicine and the Future of Healthcare
The digitization of medicine is transforming the entire healthcare system—new technologies like mobile apps and wearables bring both benefits and risks, patient access to healthcare is evolving, EHRs have created new patient safety risks, and artificial intelligence is evolving to play a role in future patient care.

Jun 06, 2018
Is It Safe to Store PHI on Remote Cloud Servers?
David McHale, Senior Vice President and Chief Legal Counsel
Cloud storage is a convenient and cost-effective solution for medical practices and facilities, but precautions must be taken to ensure stored patient data (PHI) is secure. This article has tips for choosing a cloud service provider.

Jun 05, 2018
Define Your Core Values, Transform Your Medical Practice
Brandon Betancourt, practice administrator for Salud Pediatrics in Chicago, describes how his practice defined core values to address challenges and provide optimal patient care.

May 03, 2018
Healthcare Technology Risks and Rewards: Faster, Cheaper, Safer
David Chou, Vice President/Chief Information & Digital Officer, Children’s Mercy Kansas City, shares his insights on balancing the cybersecurity risks and patient care improvements of healthcare technology.

Apr 23, 2018
Physician Beats Burnout and Restores Quality of Life—with Scribes
Hans Haydon, MD, an internal medicine physician, was distressed that time-consuming EHR documentation was driving up his work hours and stress. With the use of a medical scribe, Dr. Haydon was able to restore productivity, quality interactions with patients, and work-life balance.

Apr 05, 2018
Big Data, EHRs, and Patient Care: How Healthcare Is Evolving
Shereese Maynard, a healthcare and health IT strategist, discusses how EHRs, cybersecurity, and big data are affecting medical practice management.

Professional Education
Electronic Health Record Closed Claims Study
The Doctor's Advocate
EHR-related claims have increased continuously over the past 10 years. This analysis of The Doctors Company's closed claims teaches doctors and their staff which factors related to EHRs lead to patient injuries and the steps to take to mitigate these risks.
1.0 Credit

Dec 19, 2017
Risks in Electronic Dental Records
Donald Wood, CRNA, CPHRM, Patient Safety Risk Manager II
System and user errors result in many EHR-related dental claims.

Video Nov 06, 2017
How to Reduce the Safety Risks of EHRs
Don't just rely on technology. It is vital that you have processes in place for auditing, backing up, and cross-checking data in your electronic health record (EHR), according to Lily Talakoub, MD, FAAD, of McLean Dermatology and Skincare Center in McLean, Virginia, and The Doctors Company's EHR Closed Claims Study. Dr. Talakoub discusses the biggest risks identified in the study, including that imaging and labs are often not found or not followed up on in the EHR or errors with copy and paste, and shares the processes that her office uses to lessen these risks.

Professional Education
Telemedicine: New Tools, Emerging Risks
Awareness of the emerging risks associated with telemedicine is important as more and more practices use technology to care for patients. This activity outlines risks related to regulatory restrictions, privacy and security, inaccuracies in patient self-reporting, and symptoms that may only be detected in person. It also suggests ways to reduce risks and challenges when using telemedicine.
1.25 Credits

Video Oct 25, 2017
The Dangers of Templates in EHRs
The role of electronic health records (EHRs) as a contributing factor to malpractice claims has increased over the past three years—with incorrect use of templates being a top risk factor. This case study from The Doctors Company’s EHR Closed Claims Study illustrates that danger.

Video Oct 23, 2017
The Dangers of Copy and Paste in EHRs
The role of electronic health records (EHRs) as a contributing factor to malpractice claims has increased over the past three years—with copy and paste errors appearing in 14 percent of these claims. These cases from The Doctors Company’s EHR Closed Claims Study illustrate that danger.

Aug 28, 2017
The Search for Mary Smith
David B. Troxel, MD, Medical Director, Board of Governors
A case study illustrating the importance of researching healthcare technologies thoroughly before implementing them.
From The Doctor’s Advocate

Aug 15, 2017
Objective Review of Potential Risks in a Medical Practice Can Be Beneficial
Ted Abernathy, MD, Managing Partner, Pediatric & Adolescent Health Partners
Ted Abernathy, MD, Managing Partner of Pediatric & Adolescent Health Partners discusses his experience with an assessment service offered by The Doctors Company which provided his practice with a comprehensive checkup of key areas and customized action plan.

Video Jun 27, 2017
Evolving Patient-Facing Technologies
Patient-facing technologies are rapidly transforming. The federal government gave $30 billion to digitize the healthcare industry over the last five years, creating strong interest and advancements in health technology among technology companies. However, there are still things that must be worked out in order to ensure measurements in new tools are accurate, advice given to patients is appropriate, and that there is clear guidance when patients should see a doctor rather than manage their own care.

Video Jun 27, 2017
The Impact of Patient Portals
Patient portals are weaving together the doctors’ and patients’ electronic worlds, which is becoming increasingly important as the healthcare industry becomes digitized. The patient portal gives patients a look into the electronic health record (EHR) and enables them to do basic transactions such as scheduling appointments and requesting prescription refills. Currently, some patient portals even provide patients access to open notes, paving the way for all patient portals to provide this access in the future.

Video Jun 27, 2017
Artificial Intelligence vs. Healthcare
Will doctors be replaced with computers? In this digital age, technology like IBM’s computer Watson is creating uncertainty about human-powered professions, including those of physicians. This video describes how the need for empathy and the ability to evaluate hundreds of salient points at once will preserve the careers of physicians.

Video Jun 27, 2017
Democratizing Healthcare
Healthcare will soon be democratized as patients’ increased access to technology enables them to more easily manage their own healthcare. The positive side of the patient’s new role is that they can diagnose and treat minor issues, but the downside could be a patient not seeing a doctor when it’s necessary to see a credentialed expert.

Video Jun 27, 2017
What Will Medicine Look Like in the Future?
What do physicians, patients, and industry professionals think healthcare will look like in the future? Interviews with 100 physicians, nurses, patients, and hospital CEOs reveal an optimistic outlook for the future of medicine.

Video Jun 27, 2017
What Healthcare Can Learn from Other Industries
As the healthcare industry makes the digital shift, healthcare professionals can look to the digitization of other industries for insight into a smooth transition. During digitization, many industries expect to see massive gains in quality and efficiency when they shift from analog, but in actuality they do not see that progress for almost a decade.

Video Jun 27, 2017
Transforming Medicine in the Digital Age
The digital age is transforming medicine. As healthcare undergoes this digital shift, there is immense pressure to improve the value of medicine with healthcare providers trying to figure out how to enhance quality, safety, the patient experience, access, and efficiency.

Video Jun 27, 2017
What Is the Solution for Interoperability?
One of the greatest challenges to achieving interoperability in the healthcare industry is identifying the technology that allows various machines and information to link. The application program interface (API), a set of software standards, is critical to achieving interoperability. Consistent APIs throughout the healthcare industry’s computer systems would enable information to be connected and shared seamlessly.

Video Jun 27, 2017
Are Patient Identifiers Required for Interoperability?
A unique patient identifier such as a social security number would improve interoperability, allowing different doctors to access patient information in different hospitals and offices across the nation. Without this identifier, every healthcare system has a different patient number and interoperability is difficult to achieve at the point of care.

Video Jun 27, 2017
How Wearables Are Changing Healthcare
Mobile technology, including wearables, apps, mobile devices, and sensors, are changing the relationship between physicians and patients, potentially reducing the need for office visits. Information from these devices could be sent to doctors for patient monitoring. But this technology also creates challenges for doctors.

Video Jun 27, 2017
3 Ways to Improve EHRs
Electronic health records (EHRs) must improve in three areas to reach their full potential and enable physicians to provide better care. As important tools in modern patient care, today’s EHRs must improve in user-centered design, alerts and alarms, and interoperability.

Video Jun 27, 2017
Open Notes: Friend or Foe?
Open notes—or physician’s notes that are available for the patient to read—are being accessed by nearly 5 million patients in the United States today and, in the next five years, open notes will be the norm everywhere. While the concept of open notes has created concern and anxiety among many doctors, this information sharing can improve the physician-patient relationship and foster more effective treatments and better outcomes for patients.

Video Jun 27, 2017
Personalized Medicine: Hype or Hope?
The concept of personalized medicine is promising, with the possibility of treatments and care based on genetic profiles. But before the potential of personalized medicine is fully realized, information technology and the healthcare industry’s understanding of links between genes and treatments must improve.

Video Jun 27, 2017
The Patient's New Role in Healthcare
Technology is changing the role of patients in healthcare. In the future, patients will have more access to the same tools and information that doctors have, enabling them to manage their own care. While this technology and increased access to information can be beneficial, it can also create the illusion that patients don’t need to see a doctor and patients may decide they are going to completely manage their health outside the supervision of an expert.

Jun 14, 2017
How Medical Scribes Are Trained—And Used—Varies Widely
Jeffrey A. Gold, MD, Professor of Medicine, Director of Simulation, Oregon Health and Science University
Though it is the fastest growing medical field, there is little regulation or standardization for training medical scribes.

Jun 12, 2017
Cybersecurity Must Be Part of Every Healthcare Professional’s Job
Craig Musgrave, CIO, The Doctors Company
Recent cyberattacks have been devastating. They’ve cost billions of dollars, angered and potentially endangered patients, eroded the reputation of healthcare organizations, and left institutions and individual physicians exposed to HIPAA violations. Cybersecurity is no longer just an IT issue. Every employee and every organization needs do their part.

Video May 06, 2017
Seven Tips to Help Stop Ransomware
Preparation is key: Once you've been hit by ransomware and your hard drives encrypted, your options are incredibly limited. This video shares the top seven tips you need to know to help your medical practice or hospital prevent or recover from a ransomware attack.

Video Feb 07, 2017
3 Steps for Ransomware Defense
While no environment is completely secure from cyberattack, a healthcare organization can take steps to reduce the likelihood that it will suffer the consequences of ransomware.

Video Feb 07, 2017
Paying Cyber Ransom: Pros and Cons
If ransomware strikes a healthcare organization, the cybercriminals behind the attack will demand a payment in exchange for restored access to the organization’s data. Typically the demand is for bitcoin equivalent to less than $10,000. Paying the ransom may be an attractive option if a healthcare organization’s entire network has been compromised and no reliable backup exists. However, there are several compelling arguments against paying.

Video Feb 07, 2017
Why Cybercriminals Prefer Bitcoin
Currency is a means of exchange typically sanctioned by a central body like a government or central bank. Bitcoin, however, is a decentralized digital currency based on a public ledger secured by cryptography. As a result, bitcoin transactions are largely irreversible and untraceable. This makes bitcoin and other digital currencies attractive to cybercriminals. They give cybercriminals a means of monetizing their attacks anonymously—one reason that ransomware attacks have proliferated.

Video Feb 07, 2017
Ransomware: Do's and Don'ts
Panic is the typical reaction when a healthcare organization suffers a ransomware attack. If an organization lacks a thought-out response plan for this type of crisis, people tend to overreact. They may do things that will make it harder to recover from the attack and could increase future liability. But an organization can avoid panic by having an incident response plan in place. This plan should provide a framework of actionable steps, including what to do, who is going to do it, and what is going to happen as a result.

Video Feb 07, 2017
Patient Data Trafficked on the Dark Web
Cyberattacks in the healthcare industry have proliferated for two main reasons. One, cybercriminals can sell PHI at a high price on the dark web (the online market where stolen data is bought and sold). Two, healthcare organizations are vulnerable to cyberattacks because they lack the defenses of banks and other financial institutions. Particularly attractive to cybercriminals are midsized healthcare organizations, which in general are underprepared to counter this threat.

Video Feb 07, 2017
Ransomware Threatens Patient Care
Cybercriminals typically target healthcare organizations using malicious software, or malware. Most malware is programmed to steal data and take it outside of the network. But cybercriminals today are often choosing a different form of attack: ransomware. A ransomware attack uses encryption to prevent the healthcare organization from accessing its PHI. This puts the healthcare organization in a serious crisis, as PHI is critical to providing care to patients.

Feb 03, 2017
To Text or Not to Text
Julie Song, MPH, Patient Safety Risk Manager II, and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education.
Without appropriate safeguards, texting can lead to violations of the Health Insurance Portability and Accountability Act (HIPAA).

Dec 14, 2016
Perspectives on the Future of Medicine
Richard E. Anderson, MD, FACP, Chairman and CEO, in conversation with Robert M. Wachter, MD
From The Doctor’s Advocate

Oct 26, 2016
Optimize the EHR: Better Workflow Means Better Work-Life Balance
Chad Anguilm, Director of Professional Services, Medical Advantage Group. Medical Advantage Group is a wholly owned subsidiary of The Doctors Company.
There are tools that can streamline patient care and payment workflows in the electronic health record (EHR). By dedicating time and effort up front to optimize the EHR, physicians can get relief from administrative tasks, reduce duplicate entry of data, and save time by not having to search for records in multiple places.

Dec 07, 2015
Heed Those EHR Alerts
Jacqueline Ross, PhD, RN, Senior Clinical Analyst, Department of Patient Safety and Risk Management, and Susan Shepard, MSN, RN, Director, Patient Safety and Risk Management Education
EHR system design and human factors can affect patient safety.
From The Doctor’s Advocate

Apr 13, 2015
Damage Control: Dealing with Online Patient Complaints
Susan Shepard, MSN, RN, Director, Patient Safety Education, and David O. Hester, FASHRM, CPHRM, Director, Department of Patient Safety and Risk Management.
There is no easy remedy to completely eradicate negative comments once they are on the Internet.

Sep 01, 2014
The Internet: Friend or Foe to Physicians
Robin Diamond, JD, RN; AHA Fellow-Patient Safety Leadership; Senior Vice President, Patient Safety.
Physicians must use care in dealing with Internet review sites used by consumers.

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