Medical Records and Documentation

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 Florida Dental Practices
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. This course is specific to Florida statutes and reflects regulations effective in February 2018 for dentists licensed by the Florida Board of Dentistry.
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 04, 2021
Cognitive Assessments in Primary Care: Preparation and Tools May Mitigate Diagnosis Risks
Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company, Part of TDC Group
Recent reimbursement changes by the Centers for Medicare and Medicaid Services (CMS) allow primary care providers to meet their patients’ mental health needs and help build their practices by performing cognitive assessments.

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 21, 2021
Medical and Dental Record Retention
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Having access to well-maintained patient records helps medical and dental professionals ensure continuity of care. It can also protect them against any future professional liability claims, licensing board complaints, and peer review inquiries.

Jul 16, 2021
Medical and Dental Record Issues: Frequently Asked Questions
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
We answer questions frequently asked by members about medical and dental records, such as length of retention, how to destroy hard copy paper records, and creating backups of electronic health records.

Jul 14, 2021
12 Strategies for Success With Open Notes in Healthcare: The Cures Act
Chad Anguilm, MBA; Richard F. Cahill, JD; and Kathleen Stillwell, MPA/HSA, RN
On April 5, 2021, the 21st Century Cures Act prohibition on information blocking, also known as the requirement for open notes, went into effect. All providers who use electronic health records (EHRs) must comply, and patients must be able to access information in their EHRs “without delay.”

Jul 14, 2021
Open Notes in Healthcare: The Good, the Bad, and the Ugly of the Cures Act
Chad Anguilm, MBA; Richard F. Cahill, JD; and Kathleen Stillwell, MPA/HSA, RN
Patient access to records is not new, and neither is the Cures Act, which dates to 2016. What is new is the requirement that patients have electronic records access that is fast and easy. This requirement is expected to result in more patients—still a small proportion overall, but more patients—accessing additional EHR information, including providers’ notes.

Jul 14, 2021
Open Notes: Healthcare Providers Should Prepare Now for 2023 and the Cures Act
Chad Anguilm, MBA; Richard F. Cahill, JD; and Kathleen Stillwell, MPA/HSA, RN
The 21st Century Cures Act is a multiphase, multidomain piece of legislation whose requirements for healthcare providers are in effect now, and increase over time. Between pushing for electronic health record (EHR) interoperability and funding vast, ambitious research and data-collection initiatives, the act attempts to harness our collective data-gathering power for medical good.

Jul 14, 2021
What Open Notes Exceptions Does the Cures Act Allow?
Chad Anguilm, MBA; Richard F. Cahill, JD; and Kathleen Stillwell, MPA/HSA, RN
As of April 5, 2021, patients must be able to access information in their electronic health records (EHRs) “without delay.” Unless an exception applies, clinical notes must not be blocked. But what exceptions to open notes does the Cures Act allow—or in some cases, require?

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

Jun 17, 2021
Deferred, Delayed, Disrupted: Mitigating Risks from Care During COVID-19
Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company and TDC Group
The pandemic has disrupted healthcare so thoroughly that in some sense, COVID-19 has affected all of healthcare. The effect on care has been stunning in magnitude. By mid-2020, more than 40 percent of U.S. adults had delayed medical care or avoided it entirely, including care for urgent and emergent complaints.

Jun 09, 2021
Prevent, Communicate, Document: Medical Malpractice Data Help Us Manage Risk
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company, and for the TDC Group of Companies
Medical malpractice data provide a rich source of information, offering insights into high-risk specialties, medical conditions, and procedures that result in claims.
From The Doctor’s Advocate

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
Pain Management - A Closed Claim Analysis Looking at Risks and Lessons Learned
For the first time, The Doctors Company has published an analysis of lawsuits and claims filed against pain management physicians. This study completed in 2020 provides quantitative and qualitative information that a physician who practices pain management, including interventional approaches to treatment would find useful in mitigating the risks of unintended outcomes or harms. This study breaks down where most patient injuries occur, what those injuries are, and the lessons learned from those claims.
1.3 credits

Professional Education
A Deep Dive into Managing Orthopedic Risks (FORPG)
This course identifies the systems and processes that present risks for patient harm and have significant impact on patient outcomes in the orthopedic practice. The course draws from the results of the Orthopedic Office Practice Self-Assessments completed by The Doctors Company, members of the Florida Orthopedic Risk Purchasing Group, and from other orthopedic practices who are members of The Doctors Company.
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

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

Feb 03, 2021
Curbside Consultations: Patient Safety and Legal Risks
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education; and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Physicians should be aware of the potential liability of informal "curbside" consultations, especially if expectations between the physicians are not clearly communicated.

Professional Education
HIPAA Fundamentals: 2021 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.
1.0 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

Dec 23, 2020
Orthopedics Case Study: The Danger of EHR Templates
Robin L. Wessels, MBA, RN, Assistant Vice President, Department of Patient Safety and Risk Management, The Doctors Company
This example of an orthopedic claim involving accurate medical record documentation illustrates the importance of exercising caution when using EHR templates.

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

Dec 14, 2020
How Medical Scribes Are Trained—And Used—Varies Widely
Jeffrey A. Gold, MD, Professor of Medicine, Vice Chair for Quality and Safety, Department of Medicine, Oregon Health and Science University
Though it is the fastest growing medical field, there is little regulation or standardization for training medical scribes.

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

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
Medical Error Prevention
The purpose of this monograph and continuing medical education activity is to provide physicians with the most current information regarding the prevention of common performance and diagnostic errors.
2.0 credits

Oct 20, 2020
Cybersecurity Insurance for Medical Practices—The Basics
Rachel Patrizzo, VP, Cyber, TDC Specialty Underwriters
More medical practices are purchasing an insurance policy to cover the substantial costs of a data breach. Here is an overview of what your practice can expect from a cybersecurity policy.

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

Oct 13, 2020
COVID-19 Administrative and Medical Record Documentation: Prepare for Future Lawsuits
Debbie Kane Hill, MBA, RN, CPHRM, CPPS
For months, physicians and practice managers have been in crisis mode due to COVID-19 and have faced daunting challenges daily. What the future holds relative to the evolution of COVID-19 remains unknown, but it is certain that litigation for COVID-related claims is on the horizon and will impact physicians in all medical specialties and practice models.

Professional Education
Cauda Equina Syndrome: A Failure to Diagnose
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when patient assessments are incomplete, having a narrow diagnostic focus, or diagnostic test issues. Other factors that hinder timely diagnoses include failure to appreciate signs and symptoms, lack of consults, and failure to respond to repeated patient concerns/symptoms.
0.5 credit

Sep 21, 2020
Obtaining Informed Consent in Teaching Institutions
Richard Cahill, JD, Vice President and Associate General Counsel
Given the nature of teaching institutions—where individuals in training participate in patient care to varying degrees—the informed consent process is more complex and can present additional liability risks.

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.

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 15, 2020
The Defensible Medical Record
Richard F. Cahill, JD, Vice President and Associate General Counsel
Medical records play a pivotal role in the delivery of healthcare and serve a critical function in routine clinical operations.

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

May 07, 2020
Informed Refusal
Richard F. Cahill, JD, Vice President and Associate General Counsel
Documenting a patient’s refusal of test or treatment options is key to minimizing risk exposure.

May 07, 2020
Informed Consent: Substance and Signature
Robert Morton, CPHRM, CPPS, Assistant Vice President, Department of Patient Safety and Risk Management
Informed consent protects and informs both the patient and the physician.

Apr 29, 2020
The Faintest Ink: Documentation to Defend Quality Patient Care
Carol Murray, RHIA, CPHRM, Senior Patient Safety Risk Manager
Complete and timely documentation of the medical record not only enhances patient care, but it also serves to strengthen your credibility if you are called upon to defend that care.

Apr 16, 2020
Shoulder Dystocia Documentation: Implementing a Protocol
Pamela Willis, BSN, JD, Patient Safety Risk Manager II
Shoulder dystocia claims have traditionally been among the most problematic to defend.

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 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
Analysis of Medical Oncology Claims
An analysis of The Doctors Company's closed oncology claims reveals drivers related to diagnosis, care management, and medication management. In addition, the analysis identifies related drivers that are often the underlying reasons that patients file claims.
1.0 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

Dec 11, 2019
Cultural Diversity Creates Language Barriers: Reducing Claims with Multilingual Patients
Rich Cahill, JD, Vice President and Associate General Counsel, and Susan Shepard, MSN, RN, Senior Director, Patient Safety Education, The Doctors Company
Clear and unambiguous communication constitutes the key component of the physician-patient relationship. Proactively implementing office procedures to promote optimum communication reduces the risk of disputes.

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.

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.

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

Professional Education
Alzheimer’s Disease and Related Dementias Evaluation and Diagnosis
The second course introduces The Alzheimer's Project Evaluation Algorithm and Evaluation Instruments, and focuses on differential diagnoses. The course includes ideas for how to prepare and engage in a sensitive dementia diagnosis disclosure with patients and caregivers.
1.5 credits

Professional Education
Dementia: Pharmacological Management of Behavioral and Psychological Symptoms
This activity includes three video lectures and is the sixth in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's and related dementias. This course focuses on the selection and appropriate usage of psychotropic prescription medications to manage the behavioral and psychological symptoms most frequently exhibited by patients with Alzheimer's and dementia diagnosis.
1.3 credits

Professional Education
Dementia Screening Among Adults with Cognitive Decline
The first course introduces The Alzheimer’s Project and highlights the increasingly important role of primary care practitioners in dementia care. It presents The Alzheimer’s Project Cognitive Impairment Screening Algorithm and Screening Instruments, and it addresses reversible conditions that may present similar symptoms to cognitive impairment. The course incorporates four videos, each followed by a series of related questions.
1.3 credits

Professional Education
Physical Examination and Its Impact on Outcomes
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.
0.8 credit

Professional Education
Neurological Case Study: Management of the Surgical Patient
This Claims Corner examines a neurosurgical case that alleges several failures to assess and treat a patient in a timely manner. It also highlights the importance of communicating with physicians and advanced practice providers involved with post-surgical care.
0.5 credit

Professional Education
Oral-Maxillofacial Surgery Informed Consent
Informed consent involves more than a patient signing a form. This activity explains how to enact an informed consent process based on best practices in dentistry and oral surgery.
1.0 credit

Professional Education
Ob/Gyn: Telephone Communications
The most frequent inconsistent practice found in the Practice Risk INSIGHT assessments was telephone communication (22 percent not met). When appropriate and adequate systems are in place, the physician is less at risk for having a suit filed. This case-based study provides insights and risk management techniques to lessen the frequency and severity of such a claim.
0.5 credit

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

Professional Education
Preventing Adverse Outcomes When Treating Children
The Doctors Company studied claims filed on behalf of pediatric patients that closed over a 10-year period from 2008 through 2017. You are provided the most common types of claims and includes expert insights into the specific elements that led to patient injury, and risk mitigation strategies.
1.0 credit

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.

Jan 28, 2019
Smile! The Doctor Is on Camera: The Pros and Cons of Recording Office Visits and Procedures
Rich Cahill, Vice President and Associate General Counsel
As smartphones have become ubiquitous—giving patients a video and audio recorder that’s always at hand—the question of whether or not these devices should be allowed in the clinic or hospital setting is becoming increasingly more common. The issue of allowing patients to record their appointments requires balancing potential privacy and liability risks with the potential benefits of improved patient recollection of instructions and treatment adherence.

Professional Education
Medicare Fraud and Abuse: Prevention, Detection, and Reporting
Created by the Centers for Medicare and Medicaid Services (CMS), this activity is designed for all Medicare providers. You will learn what CMS defines as fraud and abuse, how the government fights it, and how to report it.
2.3 credits

Professional Education
Medical Office Assessments Reveal Hidden Liabilities
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

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.

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.

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.

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 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.

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 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 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
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.

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: 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
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.

Sep 23, 2016
The Perils of Printing an Electronic Health Record
David B. Troxel, MD, Medical Director, Board of Governors
A design flaw in an electronic health record system led to a malpractice claim against our insured cardiologist.
From The Doctor’s Advocate

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