Regulatory Issues

Change is a-comin'!

imagesThe only constant in life is change.  Autumn is upon us; leaves are changing and the weather is cooler. Great things lie ahead; however, in order for us to experience those great things, change must happen.  Today is the official beginning of ICD-10 coding. Most - if not all of us have dreaded this for a few years now. This new coding system is a mandate by the World Health Organization and the US is the last country to make the transition to it.  Hopefully you've had a good amount of training in this new coding system and have tools at your disposal to help you meet this challenge.

One of the keys to success in life is learning to embrace change.   Embrace this new ICD-10 challenge and realize that years from now you'll  likely look back and may not even be able to remember what ICD-9 was all about!  ICD-10 will become your "new normal". Without change there is no progress. Change is GOOD!

Common Causes of Medical Errors & What You Can Do

images (1) The Florida Board of Medicine has a "One Strike - You're Out" Rule.  This means if a physician performs a surgery on the wrong patient, does a wrong procedure, wrong side or wrong site surgery, the physician loses his or her medical license. This law was enacted after an incident which occurred n 1995.  An orthopedist in Tampa amputated the wrong leg on  a patient. His medical license was suspended for three years.  After three years, the physician went back to the same hospital and amputated the wrong leg on another patient!

Common Medical Errors

According a US News & World Report publication dated March 20, 2015, medical errors claim more than 200,000 lives each year. Most medical errors are preventable.  According to this report, the top 5 preventable medical errors are:

  1. Medication Errors
  2. Too many blood transfusions
  3. Too much oxygen for premature babies
  4. Health-care associated infections
  5. lnfections from central lines

What You Can Do

Double check medication orders, the patient name, drug name, strength and dosage before you administer any medication. Then double check again.                                                      Be sure to always document the correct eye on the chart - especially when the patient is or may be scheduling surgery.  Many wrong site surgeries occur due to an error in charting.   You can't be too careful when caring for your patients.

When in doubt, double check and if anything doesn't seem right or if the patient questions the validity of orders STOP and don't do anything until you're certain everything is correct.

Meaningful Use, Schmeaningful Use

MU-Hot-seatI can hardly think of a greater misnomer than "Meaningful Use". The most frequent pain-point Ophthalmologists and Ophthalmic Practice Administrators and staff express to me is the onerous requirements for meeting Meaningful Use.  So much so, that I personally know of administrators and physicians who are leaving the field all together. Is that what CMS had in mind when it formulated Meaningful Use?

CMS's purported goal of "Meaningful Use" is to improve quality and safety of care including these key areas:   Protect electronic health information,  e-Prescribing ,  Clinical decision support,  Computerized provider order entry, Patient electronic access to their data, Coordination of care through patient engagement,  Health information exchange and  Public health reporting.

The problem with Meaningful Use is that due to the absurd amount of effort required to comply with these measures, Meaningful Use may not improve patent care, it may actually detract from it.  The time and resources which must be invested in meeting these government imposed guidelines could be better spent on actually providing the quality patient care.

The greatest frustration is to those who entered the medical field with the noble cause of helping to heal. When the reality of the incredible burden CMS has placed on them sets in, there is frequently a state of despair, frustration and the feeling of helplessness.  After all, who can fight City Hall?

I do not know what the answers are. They are bigger than I, but something must change. I believe these government mandates which unfortunately, have become the focus of our practices will go down in history as a turning point and one of the greatest failures in the history of medicine.