Risk Watch e-column
July 2005
A monthly update of risk management news, issues and items of interest
Kaiser Fined for Patient Info Release
The California Department of Managed Health Care (DMHC) fined Kaiser Foundation Health Plan $200,000 on June 20 for posting private patient health information on a public website.
The test site was launched in 1999 as part of a program to make medical records available to Kaiser members and their physicians via the Internet. The site included confidential patient information, such as names, addresses, phone numbers and lab results. But it was always accessible to the public, in violation of state law.
The site remained public until this past January, when a whistle-blower brought the matter to the attention of federal civil rights authorities. Kaiser has since informed the approximately 150 health plan members who may have been affected.
The fine is the largest the DMHC has imposed against a health insurer for a patient confidentiality violation. Kaiser officials said the incident was an oversight and would not happen again.
(Sources: DMHC, San Francisco Chronicle, San Jose Mercury-News)
Study: Computers in Exam Rooms Helpful
Making computer terminals available to physicians in medical examination rooms appears to improve patient communication and comprehension, according to a new study.
Researchers examined how 313 patients reacted when eight physicians at a primary-care medical office near Portland, Oregon, installed computer terminals in their exam rooms.
Physicians involved in the study used the computers in 82% of patient visits. Common uses included showing patients such items as charts indicating how their blood pressure was responding to medication and copies of their X-rays.
According to the study, patients said use of the computer gave them a clearer understanding of their diagnoses and treatments, and of how their physician decided on a course of action.
The study is available at the Journal of the American Medical Informatics Association website at www.jamia.org.
(Source: Modern Physician)
Feds Limit Prosecution of HIPAA Criminal Violations
Penalties for criminal violations of the Health Insurance Portability and Accountability Act (HIPAA) medical privacy rule apply to providers and health insurers but might not apply to their employees or others, according to a June 1 Department of Justice (DOJ) opinion.
The DOJ said the rule applies to “covered entities” — such as providers and health insurers — and, as a result, only those entities can face prosecution for criminal violations of the regulation. Penalties include up to $250,000 in fines and 10 years in prison.
The agency said that individuals who violate the rule could still face penalties under state laws or other federal laws — such as those that address identity theft and the fraudulent use of computers — and as a result of civil lawsuits filed by patients.
(Source: New York Times)
Study: PDAs Can Reduce Prescription Errors
Using personal digital assistants (PDAs) to order prescriptions can help reduce the incidence of medication errors, according to a new study.
Researchers found that use of the devices led to significant reductions in errors of legibility and omissions, and less-frequent use of abbreviations and symbols. The study was presented at the National Patient Safety Foundation Congress, held May 4-6 in Orlando, Florida.
Researchers analyzed handwritten orders of 78 physicians over a six-month period. Half of the physicians were randomly selected to be trained in using PDAs to write prescriptions. The study compared the prescriptions completed by hand with those done on a PDA. Results included the following:
- Incidence of illegible prescriptions decreased from 9% to less than 3%.
- Omission of patient age or birth date on prescriptions fell from 95% to 59%.
- Use of symbols declined from 77% to 47%.
(Source: Modern Physician)
