HIPAA, Privacy, and Confidentiality

Professional Education
HIPAA Fundamentals 2022–2023 Edition
This on-demand program provides an orientation to the basic requirements of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA gives patients many rights with respect to their health information. This program provides details on the HIPAA Privacy, Security, and Breach Notification Rules, such as the type of information that is protected, who must comply with the rules, and how patient information can be used and disclosed. This on-demand program includes many resources useful to staff training.
1.5 credits

Professional Education
Safe Opioid Prescribing for Physicians and Dentists
Opioids play an important role in pain management—both in the acute and the chronic setting, but a variety of causes have contributed to an opioid-related epidemic leading to addiction and death. There has also been substantial misuse of opioids by prescription and by diversion.
2.5 credits

Professional Education
Clinical Presentations Cause Delays: Failure to Diagnose Myocardial Infarction
In reviewing closed malpractice claims, The Doctors Company identified missed or delayed diagnosis of myocardial infarction (MI) in the ambulatory internal medicine setting as a reoccurring problem. This course highlights the importance of recognizing the varying clinical presentations of MI and contributing factors associated with failure to diagnose and treat. Assumptions, lack of a thorough history and physical, communication failures, and failure to recognizing atypical signs and symptoms are highlighted in this case study.
0.5 credit

Professional Education
Delayed Diagnosis of Stroke
In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke.
0.5 credit

Professional Education
Cervical Cancer Claims: A Review in Gynecology
Cervical cancer medical negligence claims are reviewed over a ten-year period to identify the major case types in which the gynecologist is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense physician experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
1.0 credit

Professional Education
Alzheimer's – 4 Addressing Patients' and Families' Needs through the Disease Stages of Dementia
This activity includes seven video lectures and is the fourth in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This fourth course covers life planning through disease stages, assessing and assisting caregivers, improving communications, utilizing community resources, and end of life decision-making. These sensitive conversations with patients. The course finishes with a focus on dementia resources, effective communication strategies, and understanding when it is time to make a referral to a specialist.
1.8 credits

Professional Education
Alzheimer's – 2 Evaluation and Diagnosis of Alzheimer’s Disease and Related Dementias
This activity includes eight video lectures and is the second in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This second course introduces the Alzheimer’s project evaluation algorithm and evaluation instruments and focuses on differential diagnoses. Finally, the course discusses how to prepare and engage in a sensitive dementia diagnosis disclosure with patients and caregivers.
1.5 credits

Professional Education
Alzheimer's – 3 Addressing and Managing Behavioral and Environmental Symptoms of Dementia
This activity includes eight video lectures and is the third in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This third course focuses on using the DICE method to assess behavioral symptoms of dementia and create and evaluation treatment plans. This course also covers the careful use of medication during disease management as wells as common behavioral issues with dementia patients including tools for management of these behaviors.
1.3 credits

Professional Education
Alzheimer's – 1 Screening for Dementia Among Adults with Cognitive Decline
This activity includes eight video lectures and is the first in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This first course focuses on introducing the Alzheimer’s Project and highlighting the increasingly important role of primary care providers in dementia care. This course also introduces the Alzheimer’s Project cognitive impairment screening algorithm and screening instruments and covers addressing reversible conditions that may present similar symptoms to cognitive impairment.
1.3 credits

Professional Education
Prevention of Dental Errors for Dental Practices
Few dental errors are attributed to faulty judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors: wrong-site surgery, improper performance of dental procedure, wrong or unnecessary treatment or procedure, retention of foreign body during treatment, and diagnosis related. We analyzed loss prevention measures in tandem with the elements necessary to conduct a credible and thorough root cause analysis (RCA) to reduce system failures, respond to sentinel events, prevent dental errors, and improve patient safety. The purpose of this continuing dental education activity is to provide dentists with the most current information regarding the prevention of common performance and diagnostic errors. The course covers: • Identification of the most common quality-of-care violations. • Illustrative case studies detailing prevalent diagnostic and performance errors. • The necessary elements of an RCA. • Safety systems in healthcare organizations. • Risk management measures designed to prevent dental errors and increase patient safety.
2.0 credits

Professional Education
Patient Relations: Spotlight on Challenging Situations
The Doctors Company’s dedicated patient safety risk managers deliver a wide range of expert services and resources to our members—including personal telephone consultations to help guide members through challenging situations. A recent review of our call data shows that “patient relations” and “patient termination” consistently appear as the top reasons that members request assistance. The following strategies can help prevent challenging patient situations and provide guidance if one occurs.
0.5 credit

Professional Education
Aducanumab for Treatment of Alzheimer's Disease – Controversy and Appropriate Communications
Panel discussion among neurologists and geriatric psychiatrists to clarify controversial issues surrounding the FDA’s recent approval of Aducanumab for treatment of Alzheimer's disease, and appropriate messaging to patients and family members. Following their presentations, the panel experts will conduct a question-and-answer session.
1.5 credits

Professional Education
Pathologists and Surgeons Can Collaborate to Reduce Diagnostic Error
The Doctors Company has updated the claims filed against pathologists between the years 2015 and 2020. The information provides quantitative and qualitative data that a pathologist and surgeon would find meaningful in reducing diagnostic error. This program provides a breakdown of where patient injuries occur involving pathologists and surgeons and how collaboration between the two disciplines can improve patient outcomes.
1.0 credit

Aug 05, 2021
Top Seven Tips for Telehealth
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group
Now that practitioners and patients are more comfortable with and able to resume in-person visits, virtual visits have declined—although not to the same level as prior to the pandemic. Many believe there will continue to be a desire on the part of patients and practitioners to use telemedicine for healthcare delivery going forward.

Professional Education
Patient Safety in Spine Surgery
Spine surgery requires a series of best practice patient safety interventions to reduce the frequency and severity of patient harm while giving the care team the resources to mitigate such harm. Evidence-based clinical methods, pathways, and tools coupled with an evolving culture of patient safety through effective communication, teams, and teamwork has shown to reduce patient harm exponentially. Patient and clinical team experiences are enhanced while ensuring a learning culture is built that approaches surgery from both a technical and nontechnical approach alike.
1.3 credits

Jul 09, 2021
Requests to Amend a Medical or Dental Record
Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager, and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Patients have the right to request amendments to their medical or dental records, but providers have the right to determine if the changes will be made. Following the guidelines presented here can help ensure clear communication and documentation.

Professional Education
The Need for Close Monitoring in Hyponatremia: Osmotic Demyelination Syndrome
In reviewing closed malpractice claims, The Doctors Company identified mismanagement of sodium levels during correction of severe hyponatremia as a serious problem that can result in catastrophic permanent neurological injury due to osmotic demyelination syndrome (also known as central pontine myelinolysis). This article highlights the importance of close monitoring of sodium levels during correction of severe hyponatremia, with a slow and controlled pace of sodium correction. Contributing factors discussed include clinical judgment with regard to rate of rise of sodium levels, patient monitoring, choice of practice setting, and communication between providers, especially at points of transition in care.
0.5 credit

Professional Education
Risky Practices: Hidden Liabilities Identified by Medical Office Assessments
Office practice assessments by The Doctors Company's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can "fall through the cracks" and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas and offer strategies to minimize liability.
1.3 credits

Professional Education
Telehealth: Review Your Service Components
Many practices implemented telehealth overnight in response to pandemic restrictions on elective care. Practices already using telehealth saw huge increases in volume. This program presents a roadmap for practices to evaluate their telehealth implementation using the best practice tips identified herein and their own lessons learned.
0.8 credit

Professional Education
Dictation Errors in the Emergency Department
The Doctors Company identified dictation errors as a significant patient safety risk factor. The following case highlights the importance of timely recognition of dictation errors to ensure accuracy of the permanent electronic health record (EHR). This is particularly important when using a voice recognition program to document encounters in the busy emergency department. In this case, the voice recognition system was Dragon Direct Voice Recognition Program.
0.5 credit

May 14, 2021
Managing Healthcare Practice Operations during COVID-19
Debbie Kane Hill, MBA, RN, Senior Patient Safety Risk Manager
As COVID-19 cases continue to rise and fall across all regions of the United States, practices must adapt and adjust their operations according to regional mandates, which can transition overnight with the shifting environment. For areas where there is a resurgence of the virus or as new strains of the virus emerge, you will need to be attentive to newly imposed restrictions. If disease transmission slows further, authorities may lift additional restrictions.

Professional Education
Breast Cancer Claims – A Review in Gynecology
Breast cancer medical negligence claims are reviewed over a ten-year period to identify the major case types in which the gynecologist is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense physician experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
1.0 credit

Professional Education
Interventional Radiology: Analysis of Closed Malpractice Claims
Studying interventional radiology malpractice claims provides an understanding of drivers of lawsuits and patient injuries that result. By analyzing these claims and identifying the contributing factors involved, risk mitigation strategies can be developed and implemented reducing adverse patient outcomes and increasing patient safety.
0.8 credit

Mar 03, 2021
Healthcare Cybersecurity During COVID-19 and Beyond: How to Protect Your Practice
Kevin Casey, JD, CIPP/US, Assistant Vice President Claims, TDC Specialty Underwriters, Part of the TDC Group
Throughout the pandemic, cybercriminals have found additional opportunities to target the healthcare industry. Recent developments in ransomware sophistication and tactics are cause for added concern.
From The Doctor’s Advocate

Professional Education
TeamSTEPPS® Teamwork Training in the Office Practice
This course provides an overview of the evidence-based TeamSTEPPS® concepts, tools, and strategies based on the four areas of 1) leadership, 2) mutual support, 3) situation monitoring, and 4) communication. TeamSTEPPS training provides teachable/learnable skills that improve communication and teamwork among healthcare professionals in both acute care and ambulatory care environments.
1.5 credits

Professional Education
Diagnostic Radiology: Analysis of Closed Malpractice Claims
Studying diagnostic radiology malpractice claims provides an understanding of drivers of lawsuits and patient injuries that result. By analyzing these claims and identifying the contributing factors involved in these, risk mitigation strategies can be developed and implemented reducing adverse patient outcomes and increasing patient safety.
0.8 credit

Professional Education
Diagnostic Radiology: A Failure to Diagnose
In reviewing closed malpractice claims, The Doctors Company identified delayed diagnosis of a malignancy as a reoccurring problem. The following highlights the importance of recognizing a spinal abnormality and recommending further follow up of a lesion seen on imaging. Contributing factors include misinterpretation of radiologic studies, narrow diagnostic focus, lack of communication and failure to establish a differential diagnosis.
0.5 credit

Professional Education
HIPAA for Managers: The High-Level View
The program explores and defines HIPAA policies and procedures, business associate agreements, security assessment and analysis, training requirements, HIPAA compliance requirements, breach events, and informed consent.
1.0 credit

Professional Education
Prevention of Diagnostic Error in Primary Care
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden. Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework.
1.0 credit

Professional Education
It's the Little Things: An Introduction to Enhancing Patient Relations and Reducing Risks
It's the Little Things is designed to assist medical practices with improvements in patient interactions by looking at how incorporating hospitality as a focus makes a difference. It has been developed to improve multiple facets of patient interaction.
1.3 credits

Professional Education
Spotlight on Diagnosing PE/DVT
The overall incidence of venous thromboembolism (VTE) —including both deep vein thrombosis (DVT) and pulmonary embolism (PE) —is one case per 1000 patient years. Accurate and timely diagnosis of VTE can be improved with the use of diagnostic guidelines such as Wells criteria and scoring for both DVT and PE.
0.5 credit

Nov 23, 2020
Ransomware Attacks Against Healthcare Providers Are on the Rise
By Kevin Casey, JD, CIPP/US, Assistant Vice President Claims, TDC Specialty Underwriters
The proliferation of simple-to-use “ransomware-as-a-service” kits is partially to blame for the rise in attacks. Less technically skilled attackers are provided with free and easy-to-use tools and agree to share a portion of the ransom payment with the ransomware developer. These trends are of particular concern to the healthcare industry, as it is one of the most targeted sectors by cybercriminals. Small to midsized healthcare entities are inviting targets, because they often lack the cybersecurity sophistication to respond to attacks and are known to store, transmit, and process monetizable data.

Professional Education
Lessons Learned – Plastic Surgery Closed Claims Study: An Expert Analysis of Medical Malpractice Allegations
This course is based on the findings of a study conducted by The Doctors Company that analyzed 415 claims that closed against plastic surgeons (from July 2015–December 2018).
1.3 credits

Professional Education
Safe and Effective Opioid Prescribing – Florida Edition
The Doctors Company recognizes the opioid epidemic in this country. This course provides insights into the risks of opioid usage, as shown by malpractice claims, and how to reduce those risks both for your patient and for your practice. Approved by the Florida Board of Medicine—Controlled Substance Prescribing.
2.0 credits

Professional Education
Prevention of Medical Errors: CME Risk Management Course for Florida Practices
This activity is specific to Florida statutes and reflects regulations effective February 2020. Few medical errors are attributed to faulty medical judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors that reflect on the most common issues identified by Florida—wrong site surgery, surgery complications, cancer, Ob/Gyn related conditions, gastroenterology conditions, cardiology issues, neurological issues, and adverse drug events—that will serve as the focal point of this patient safety and risk management course.
2.0 credits

Professional Education
Telemedicine to Telehealth: Trends and Emerging Risks
This course explores challenges and risks such as privacy and security, licensure, and technology concerns that might instigate a malpractice claim. The risks overlay the inherent challenge of replicating the interaction of a traditional, in-person encounter between a provider and a patient, without compromising the standard of care. It also provides resources for clinicians and practice managers to consider when making decisions about deploying telehealth services or to improve existing services.
1.3 credits

Professional Education
Diagnostic Cardiology Closed Claims Study: An Expert Analysis of Medical Malpractice Allegations
The specialty of cardiology is complex and has underlying vulnerabilities that can put patients at risk of injury and can increase liability for cardiologists and other clinicians who treat heart patients. Understanding common areas of liability and risk exposure are a valuable way to make effective practice improvements.
0.5 credit

Aug 25, 2020
Disaster Preparedness for Your Medical Practice
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Natural disasters can occur suddenly and without warning, highlighting the importance of advance preparation. Make sure your practice has a plan in place.

Aug 07, 2020
Lessons Learned from COVID-19 in New York City: Preparation Is Key
Keith M. Blechman, MD, Plastic and Reconstructive Surgery
After some rocky early days, leaping the hurdles set by the COVID-19 pandemic has created positive outcomes for my practice, as I have made changes to become more efficient through integrated telemedicine.

Aug 04, 2020
Your Patient Is Logging On Now: The Risks and Benefits of Telehealth in the Future of Healthcare
Due to COVID-19, sweeping benefits from telehealth are still emerging—and so are its risks. Reduced infection risk and increased access to care are possible with recognition that telemedicine is not a panacea: Telemedicine is a helpful adjunct to in-person care, when supported by best known practices.

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Leaders
This activity is designed for healthcare professionals in leadership positions. It covers the principles of informed consent, crafting and disseminating an informed consent policy, and building systems to improve the informed consent process.
2.0 credits

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Professionals
This activity, designed for doctors, nurses, and other providers, examines problems with the process of healthcare informed consent. It describes the principles of informed consent and highlights the benefits gained from a good informed consent process.
2.3 credits

Jun 03, 2020
Job Shadowing: Observers and Volunteers in Medical and Dental Practices
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, Department of Patient Safety and Risk Management
Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.

Professional Education
Physician-Patient Relationship: When Does it Begin and When Does it End?
This enduring program will assist the participant in understanding the principles which form the establishment of a physician-patient relationship, as well as the concerns which may result in the need for the physician to consider terminating the physician-patient relationship. Additionally, the concepts of providing patient centered care will be presented for the learner’s consideration.
1.0 credit

Professional Education
General Surgery: Miscommunication and Inaccurate Documentation
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when documentation is inconsistent or not thoroughly read. Other factors that hinder timely diagnosis include inadequate hand-offs or referrals.
0.5 credit

Apr 09, 2020
Exclusively for Member Practices: Risk Management Fundamentals for the Practice Manager
Our complimentary program is exclusive to all member practice managers, both clinical and nonclinical, who are new to the role or seek further education regarding the application of risk management and patient safety measures (or principles) in an office-based medical or dental practice.

Apr 02, 2020
COVID-19: How to Temporarily Close Your Practice While Minimizing Risks
Richard Cahill, Vice President and Associate General Counsel; Todd Zeiter, Vice President, National Underwriting
During the COVID-19 pandemic, with patients and practices postponing care for nonemergent situations, many physicians are wondering how to temporarily reduce their hours or even close their practices—while minimizing risks.

Professional Education
Neurosurgery: Communications and System Failure Leading to Diagnostic Error (Claims Corner CME)
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when needed equipment isn’t available or when access to a patient is difficult. System failures may result when there is a lack of coordination of appropriate care among providers, or when poor communication among providers leads to missed and delayed diagnoses.
0.5 credit

Professional Education
Internal Medicine: When Personal Relationships Interfere with the Standard of Care
Physicians and dentists are often faced with the decision whether to treat friends and families without realizing the inherent risks in doing so. A review of one case will highlight some common circumstances and risks associated with the treatment of friends and family members.
0.8 credit

Video Dec 16, 2019
Artificial Intelligence in Healthcare: Benefits and Risks
A third of U.S. physicians are already using artificial intelligence (AI) in their practices, and many believe there is ample reason to think this advanced technology can help address diagnostic errors—the largest cause of malpractice claims. However, there are still unresolved questions about the risks.

Professional Education
Spotlight on Anesthesia Claims: Moving the Needle
In this course we will show how comorbidities complicated the delivery of good anesthesia care. And we will share how important a thorough history and physical is to identifying potential problems that occur in the administration of anesthesia care.
1.0 credit

Professional Education
Safe and Effective Opioid Prescribing - Georgia Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management, as delineated in Georgia Rule 360-15-.01. It also provides tools and resources to assist in educating staff and informing patients.
3.0 credits

Professional Education
Prescribing Opioids Safely
Faced with an opioid-related epidemic that continues to bring addiction and deaths, it is important to define the role of opioids for both acute and chronic pain management. This activity spotlights the epidemic and presents the Centers for Disease Control and Prevention (CDC) guidelines, regulations, studies, and emerging solutions to address the epidemic and allow for effective and appropriate use of these drugs.
2.5 credits

Professional Education
Safe and Effective Opioid Prescribing - Michigan Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and requirements delineated in Michigan’s law. It also provides tools and resources to assist in educating staff and informing patients.
3.0 credits

Nov 12, 2019
Closing or Relocating a Healthcare Practice
Physician practices close for many reasons, including physician illness or death or a decision to sell, practice solo, join another group, relocate, or retire. These patient safety and risk management tips can help make the transition easier.

Oct 31, 2019
The Algorithm Will See You Now: How AI’s Healthcare Potential Outweighs Its Risk
A third of U.S. physicians are already using artificial intelligence (AI) in their practices, and many believe there is ample reason to think this advanced technology can help address diagnostic errors—the largest cause of malpractice claims. However, there are still unresolved questions about the risks.

Professional Education
Advanced Practice Providers Closed Claims: What Can We Learn?
A recent study by the Association of American Medical Colleges predicts that the U.S. would need an additional 95,900 doctors, 22,700 NPs, and 12,800 PAs immediately if healthcare use patterns were equalized across race, insurance coverage, and geographic location. More understanding of the liability associated with APPs can help provide insight on the current situation and identify strategies that decrease risk, improve patient safety, and advance patient care.
1.0 credit

Professional Education
Dementia Q&A: What Physicians Ask About Diagnosis and Treatment
This course focuses on the common concerns and questions expressed by physicians about dementia and cognitive impairment. This course covers making the initial observation of cognitive decline and beginning a conversation with older adult patients; overcoming common barriers to making a definitive diagnosis of dementia; and managing the ongoing clinical needs of patients experiencing dementia.
1.5 credits

Video Jan 04, 2018
Disaster Preparedness for Your Medical Practice
Recent fires, hurricanes, and floods nationwide have highlighted the importance of planning for disasters. Wildfires in California forced several physicians to quickly relocate their practices―some permanently―and to move scheduled procedures to different facilities. Hurricane and flood damage in Texas and Florida left practices without power for days or even weeks. Is your practice prepared for this type of situation?

Video Nov 10, 2017
Healthcare Billing Risks
All healthcare providers are vulnerable to fines and penalties if they submit bills for reimbursement to the government or private payers. This video presents an overview of the risks to healthcare providers posed by billing errors and omissions.

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

Feb 18, 2017
Up for Review: Five Keys to Managing Online Criticism
Kevin Pho, MD, Founder and Editor, KevinMD.com
No matter how professional and caring a doctor you may be, eventually you will face criticism on the web. Here are five keys to managing that criticism.

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