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12/05/2018 - 2:24pm

With plenty of potential healthcare concerns and complications arising out of medical diagnoses and treatments themselves, errors in medical records present an unfortunate additional opportunity for improper treatment

12/05/2018 - 2:21pm

105 thinkers, including our Travis Rieder, were asked two questions. What worries you most about the future? What gives you the most hope about the future?

12/05/2018 - 2:14pm

Petrie-Flom Faculty Director Glenn Cohen discusses genome editing on Al Jazeera’s The Stream.

The post WATCH: What’s the future of CRISPR gene editing technology? appeared first on Bill of Health.

12/05/2018 - 11:05am

With plenty of potential healthcare concerns and complications arising out of medical diagnoses and treatments themselves, errors in medical records present an unfortunate additional opportunity for improper treatment.

A recent article from Kaiser Health News (KHN) discussed several examples of dangerous medical record errors: a hospital pathology report identifying cancer that failed to reach the patient’s neurosurgeon, a patient whose record incorrectly identified her as having an under-active rather than overactive thyroid, potentially subjecting her to harmful medicine, and a patient who discovered pages someone else’s medical records tucked into in her father’s records. In addition to incorrect information, omitting information on medications, allergies, and lab results from a patient’s records can be quite dangerous.

The goal of “one patient, one record” provides a way to “bring patient records and data into one centralized location that all clinicians will be able to access as authorized.” This enables providers to better understand the full picture of a patient’s medical condition. It also minimizes the number of questions, and chances of making errors, that a patient must answer regarding their medical conditions and history when they visit a provider.

Other benefits, such as cost and care coordination, also add to the appeal of centralized records.

Streamlined electronic health record systems can minimize the risk of error due to having medical information for one patient in different places. The Logansport Memorial Hospital in Logansport, Indiana, for example, recently announced plans to put a single record system in place by 2020, replacing the two separate systems—one for acute services and another for physicians—it currently has in place.

However, the importance of recording the correct information is perhaps amplified with centralized systems: if an error is made in one place, that error is then replicated throughout the system, putting patients at risk.

And as data sharing increases, there’s plenty of room for error in consolidating patient information, due to different systems’ mechanisms for information protection, sharing, storage, and classification. In addition, repeated care due to duplicate records can be quite costly.

According to Doug Brown, Managing Partner of Black Book Research, “increased risk and cost from redundant medical tests and procedures because of fragmented data trapped in silos makes tracking patients especially difficult.” Translating paper records into electronic versions, and transcription or data input mistakes also pose risks of incorrect medical records.

According to the Patient Safety Authority of Pennsylvania, 889 medication-errors in which health information technology (HIT) was a contributing factor were reported in the first half of 2016. These errors were largely related to dosages (such as omitted doses or overdosages).

And with errors underreported, the potential harmful impact of medical record errors could be even greater than the study revealed.

Estimates by the Office of National Coordination for Health Information Technology (ONC), based on information from a 2017 survey, found almost 1 in 10 individuals who accessed their medical record online requested that information in their record be corrected. The ONC brief found that 28 percent of individuals nationwide viewed their medical record online in the past year. This leaves open the possibility of many undiscovered errors among the 72 percent who did not view their online medical health records.

On the bright side, the ONC brief found that 8 in 10 of those who did access their medical record online found it to be useful and easy to understand. But unfortunately, obtaining medical records can itself be a challenge. A recent study of 83 US hospitals found a number of issues, including costs for release higher than federal recommendations, processing times above state requirements, and discrepancies between information given over the phone by medical records departments and information on medical record release authorization forms.

These problems resulted despite protections under the  Health Insurance Portability and Accountability Act of 1996 (HIPAA), which gives patients the right to request to see and get a copy of their health records and the right to correct health information. Under HIPAA, the record must also be provided at a reasonable cost, within 30 days of the request’s receipt, and in the requested format, if possible. But even with these protections in place, confusion and challenges in accessing medical records are still present.

While there is clearly room for improvement in accessibility of medical records, knowing the rights patients have with respect to medical records, reviewing records carefully, and requesting corrections of any errors will help patients defend themselves from harms of medical record errors.

And in addition to enabling patients to identify and hopefully correct incorrect medical records, reviewing medical records can hopefully produce other benefits as well. Research has demonstrated that reviewing medical records increases the likelihood that patients will follow treatment recommendations and feel that they’re engaged in their care.


Rebecca Friedman is a 2018-2019 Petrie-Flom Center Student Fellow. 

The post The Troubling Prevalence of Medical Record Errors appeared first on Bill of Health.

12/05/2018 - 10:39am

By Steve Phillips I appreciate the prior posts by Jon Holmlund and Mark McQuain regarding the recent announcement of the birth of genetically modified twins in China. Much has been written about why this should not have been done, but something very significant has been left out of most of those responses. They have failed …

Continue reading "Gene editing for genetic enhancement"

12/05/2018 - 10:06am

Public trust in the determination of death was low in the 1840s. Thus, there were books like Edgar Allen Poe's THE PREMATURE BURIAL. Sitting here in Havana at a conference on brain death, it seems that we may be approaching another era of public mistr...

12/05/2018 - 10:06am

Public trust in the determination of death was low in the 1840s. Thus, there were books like Edgar Allen Poe's THE PREMATURE BURIAL. Sitting here in Havana at a conference on brain death, it seems that we may be approaching another era of public mistrust in death determination.

12/05/2018 - 9:46am

The birth of gene-edited twin girls was announced by a young Chinese scientist He Jiankui through one of four self-made promotional videos in English on YouTube (a website officially banned in China) on November 25. Three days later, at the Second International Summit on Human Genome Editing held in Hong Kong, He revealed that another… Read more

The post He Jiankui’s Genetic Misadventure: Why Him? Why China? appeared first on The Hastings Center.

12/05/2018 - 3:30am

The Colorado Healthcare Ethics Forum (CHEF) 2019 conference will be April 11-12, 2019, at the Stonebrook Event Center in Thornton, Colorado. The title is "Promoting Health or Creating Chaos? The Ethical Implications of Disruptive Innovations in Healthcare."

CHEF is committed to promoting ethical practice and collaboration by providing education and resources for clinicians, ethicists, educators, administrators, community members, and all who have an interest in the ethical dimensions of healthcare. 

This year’s conference will examine disruptive innovations in healthcare and bioethics. Webster’s dictionary defines disruptive as, “to throw into disorder” or “to interrupt the normal course or unity of…” In other words, do disruptive technologies, practices, and policy-oriented innovations in healthcare contribute more to promoting health or creating chaos in the lives of patients, loved ones, and caregivers?

Topics for conference presentations can include: discipline-specific issues in nursing, palliative care, hospice, spiritual care, and social work; technological advances such as those in surgical, genetic, and pharmaceutical industries; national, state, and hospital health policy; economic innovations in insurance and indigent care; strategies to address upstream economic drivers of healthcare funding; and the electronic medical record. Speakers are encouraged to consider both helpful and harmful dimensions of innovations in healthcare and provide insights for dealing with chaos at both bedside and structural levels of care.

CHEF hopes to learn with and from you about creative approaches, promising practices, and other work responding to the structural issues of 21st century healthcare. We are particularly interested in practical presentations that provide diverse responses to disruptive innovations that trickle down to the bedside to create more chaos than health, more moral distress than resolution.