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Patient portal messaging systems may help reduce malpractice liability

Never mind the likely HIPAA violations that will occur when physicians and nurses start using their smartphones and iPads to message each other about patients, or worse yet, messaging patients directly  over such non-secure channels: It could also be ratcheting up your malpractice risk.

In a recent story from the athenahealth 2013 user conference, Carrie Peacock, administrator for Pulaski Surgery Clinic of Little Rock, Ark., said that malpractice concerns, on top of privacy and security issues, keep clinicians from texting or emailing patients as a part of policy.

The story behind the policy probably sounds familiar to many practitioners struggling with the same issue in the age of smartphone-connected physicians and patients. She said the clinic developed it after it was discovered one practitioner had considered permitting a patient to use his smartphone text app to send a picture of a rash to him for evaluation.

While meaningful use stage 2 promotes such electronic patient engagement outside the four walls of the physician’s office, that won’t fly — and neither does text messaging, email or social media chats related to patient care — she said. Such ad hoc communication outside the electronic medical record increases malpractice risks, according to the advice of the clinic’s insurance carrier.

Even if they were secure to a degree that satisfied HIPAA compliance, such communications are difficult to remember to document in the patient record, especially if they fall on a weekend when the practitioner is away from the office and might forget about them the next time he comes into the office.

Pulaski’s answer was a secure patient portal through which patient communications are now routed, all captured and associated with the correct patient files. Not only does it help set the clinic up for meaningful use-grade patient engagement and HIPAA compliance, it has other side benefits.

“We have a lot of patients that ask for refills” of prescriptions over the portal, Peacock said. “We also have a lot of drug-seekers, I’m sure all of you who prescribe narcotics do as well. We can see the patterns, [such as] ‘Wow, she just sought five messages for refills of her narcotic in the last week.’ It was more on the practice to make sure that information was put in when patients were calling…[the patient portal’s] been great in that aspect.”

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