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The CMG Voice

Patients trek from across the country to Longview for lower cost surgery

Posted Friday, March 8, 2019 by Tyler Goldberg-Hoss

You may have heard of patients leaving the country for lower cost medical treatment. Interestingly, now American patients are heading to the Pacific Northwest for some procedures as well.

Pacific Surgical Center in Longview is part of a growing trend within “medical tourism” of staying within the United States, but travelling to another state for less costly surgeries. One patient travelled from Nebraska for a surgery, and saved $13,000 by having it in Longview versus one near her home.

Although rare now, such travel for surgery may become more commonplace as payers of medical care, including some large corporations, find ways to save money. For now, it looks like at least Pacific Surgical Center is an early beneficiary.

To save on surgery, out-of-state patients travel to Washington’s Longview

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Using the Electronic Health Record in Medical Negligence Cases

Posted Tuesday, March 5, 2019 by Morgan Cartwright

As technology improves, institutions start to collect more and more information in order to track and evaluate a number of conditions. In terms of the Electronic Health Record, medical organizations are collecting more data about how their personnel are accessing and using the Electronic Health Record.

In the context of a medical negligence case, sometimes attorneys for the injured patient can use this collection of data to determine what went wrong with the patient’s care that caused harm.

First, the Electronic Health Record creates an Audit Trail that shows who accesses the Health Record. This could be from the time in and time out, to notes that were drafted, and even overall management of records. Attorneys can use this information to piece together what exactly happened for the patient during their medical care. If it shows that the physician’s only accessed the health record for a minimal amount of time, it would question the physician’s ability to detect or treat the condition.

Second, more recently organizations have started integrating newer programs into the Electronic Health Record to help with clinical performance. One example is a program that alerts the physician when the patient has been taking an existing medication and it is not compatible with a potential newer medication. A prudent attorney will recognize the potential advances that an organization’s Health Record has and be able to figure out if the physician ignored key signs in the Health Record or why the physician chose a particular path.

As technology improves, patients and society expect that their medical care should improve as well. With that improvement comes increased complexity for both doctors and attorneys. Both professions must recognize that the Health Record systems at organizations can help to improve physician’s clinical performance, resulting in better patient outcomes, and also allow for greater transparency when negligence does occur.

Read here to find out more:

New Malpractice Risks in Your EHR

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Some Stroke Patients May Have an Extended Chance at Thrombectomy

Posted Monday, February 25, 2019 by Morgan Cartwright

A stroke occurs when a patient has had restricted blood flow (normally due to a blood clot) to the brain and the neurons in the brain start dying. A thrombectomy is a surgical procedure in which a doctor removes a blood clot from a blood vessel/artery. Thereafter, the blood flow is restored to the brain and hopefully minimizes significant brain injury.

Over the past few decades, a number of clinical trials have tested the time frame in which a thrombectomy can be performed after the stroke started. It used to be that there were only a few hours into a stroke in which you could perform a thrombectomy that would result in any benefit to the patient. However, recent clinical trials, DAWN (24 hr range) and DEFUSE 3 (6-16hr range), have shown a possible benefit for thrombectomy of up to 24 hours after the onset of symptoms.

Unfortunately, the extended time frames are only available to a small percentage of patient groups depending on the area of the blood clot and the patient’s anatomy. So for now, it’s imperative that all stroke patients are identified for potential thrombectomy as soon as possible to avoid tragic outcomes.

The Window of Opportunity Widens: Thrombectomy’s Practice-Changing Implications in Stroke

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Communication between Technicians and Radiologists is Key

Posted Friday, February 22, 2019 by Morgan Cartwright

When taking imaging of a patient, the radiology technologist is typically the provider who sees the patient. The radiologist – the physician who interprets the images taken – rarely interacts with the patient. This means that communication between the technician and radiologist is often important to ensure the radiologist is guided in their interpretations and patients are provided optimal care.

For example, sometimes a technologist might see that a patient is particularly ill, in which case the technologist may be able to expedite the exam. In such a scenario, communicating that to the radiologist may key her or him into a critical finding on an image, or a clue that further imaging needs to be done.

Equally as important is the ability of the radiologist to communicate back to the technician regarding the images. If the technician takes images in a certain way but they aren’t showing something, the radiologist has the ability to suggest different images be taken. This symbiotic relationship of obtaining the correct images is critical to ensuring the patient is being treated properly.

While this communication furthers patient care, it also serves to foster a connection between the technician and radiologist. This allows both providers to start to develop awareness into information that is important to each other so they can do their jobs at their peak ability. Most importantly, this increased communication between the technician and radiologist leads to higher quality care and more patient safety.

A Good Tech-rad Relationship Is Vital to Patient Care

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Language Barriers in Medicine

Posted Monday, February 11, 2019 by Morgan Cartwright

The United States is becoming more and more diverse, with people immigrating here from every part of the globe. Currently, there are over 25 million people in the United States who have limited English proficiency.

Doctors who provide care to these people must recognize this and provide adequate language services to ensure a mutual understanding with the patient. Most of the time this requires the doctor obtaining a professional translator. This is most often a translator with expertise in translating in the medical field, rather than someone who just happens to speak the language of the patient. The difference can be enormous in the ability to communicate the medical terms necessary for the patient to understand care. Furthermore, when patients have questions, they must have an interpreter who is competent enough to get a complete answer.

Doctors who fail to recognize these language differences may risk performing procedures or making decisions about health care against the wishes of those with limited English proficiency.

This can open the physician up to liability. In a study of 35 malpractice cases involving translators, 32 had to do with a failure to use competent interpreters. Twelve involved failure to translate important documents, and twelve involved using family members to translate.

This population is particularly vulnerable because they may be less able to get help after they have been injured. They may not understand the legal system to take action or may have other fears of the legal system. We can only hope that as the diversity increases in this country, doctors will realize the importance of overcoming language barriers in Medicine with competent translators.

Your Legal Risks When Patients Don’t Speak English Well

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