eRecovery for eDiscovery

Updating digital discovery: It’s all on record | AMNews | 7.2.07

Digging up old e-mails and business records from a computer, backup server or PDA isn’t likely to be at the top of most doctors’ to-do lists. But if they are whisked into a lawsuit, that’s exactly what physicians must be prepared to do under new federal rules that address the discovery of electronically stored information.

Physician practices, like other businesses, are going from paper piles to digital files, and courts are catching up, experts say. Gone are the days when parties in a lawsuit could say they deleted e-mails or that electronic data are too difficult to find without facing severe penalties.

Big problem! Look what we’ve done with medical records…

Flea Makes AMNews

Blog at your own risk: Keeping online opinions anonymous can be trick | AMNews | 7.2.07

What…physician-bloggers are learning is that their Internet writings are not particularly anonymous and these online postings could put them at risk of violating patient privacy, angering colleagues or facing a malpractice lawsuit.

Looks like AMNet’s content is open to the public again.

ScanSnapTastic

What a beautiful scanner (even a Mac-centric model). I popped in a stack of 50 pages and it scans both sides, in one pass, in about 2 minutes (black-and-white). I’ve had several duplex scanner but this is by far the fastest with a very small well-designed footprint. Scans directly into Adobe Acrobat 8 Professional.

My first purchase for my “law office” — oh yea, there’s that matter with the bar exam next month…

Robbing ‘Hood

Lawsuit over Scripps’ billing of uninsured a class action | SDUT | 6.29.07

A San Diego Superior Court judge has granted class-action status to a lawsuit accusing Scripps Health hospitals of charging exorbitant amounts to uninsured patients who often aren’t able to pay the bills without risking financial ruin.

The suit alleges that uninsured Scripps patients pay as much as four times more than patients covered by Medicare or private insurance for the same procedures. Those who don’t pay their bills are sometimes reported to collection agencies that use aggressive tactics to pursue payments and cause damage to patients’ credit, say attorneys for plaintiff Phillip Franklin.

Is this robbing Paul to pay Peter? It seems all the major health systems need to go to court before they “get it.” You can’t cost-shift your competively-reduced-rates onto the uninsured. Public policy, public angst, and the legal system will cure you of that malady.

Conflict Addiction

Conflict Alleged in Drug Firms’ Education Role | WP | 6.27.07

Drug companies have become the biggest sponsors of continuing medical education courses in recent years, even at the nation’s top medical schools, a development that critics say raises health-care costs, skews doctors’ treatment decisions and allows the industry to skirt laws against advertising “off-label” uses for its products.

Now, nearly two-thirds of the cost of continuing education courses sponsored by medical schools, popular for their prestige, are paid for by drug and medical device companies and other commercial interests, figures show. Overall, commercial sponsors pick up about half of the $2.25 billion annual cost of the courses doctors must attend to keep their licenses.

TANSTAAFL

Disruption Found

Testing Out the iPhone
| WSJ | 6.27.07

One of the most important trends in personal technology over the past few years has been the evolution of the humble cellphone into a true handheld computer, a device able to replicate many of the key functions of a laptop. But most of these “smart phones” have had lousy software, confusing user interfaces and clumsy music, video and photo playback. And their designers have struggled to balance screen size, keyboard usability and battery life.

We have been testing the iPhone for two weeks, in multiple usage scenarios, in cities across the country. Our verdict is that, despite some flaws and feature omissions, the iPhone is, on balance, a beautiful and breakthrough handheld computer

Apple’s iPhone isn’t perfect, but it’s worthy of the hype | USAT | 6.27.07

The mania over Apple’s iPhone launch has created stratospheric expectations that are near impossible to live up to. Yet with a few exceptions, this expensive, glitzy wunderkind is indeed worth lusting after.

That’s saying a lot. After months of hype, Apple has delivered a prodigy — a slender fashion phone, a slick iPod and an Internet experience unlike any before it on a mobile handset.

The iPhone Matches Most of Its Hype | NYT | 6.27.07

As it turns out, much of the hype and some of the criticisms are justified. The iPhone is revolutionary; it’s flawed. It’s substance; it’s style. It does things no phone has ever done before; it lacks features found even on the most basic phones.

Graphic and Video

Not too bad in my prediction—just 2.5 years early.

Civil Dumping

Legal actions target patient dumping on L.A.’s skid row | LAT | 6.27.07

Prosecutors filed civil complaints on Tuesday accusing two hospitals and a transportation services firm of dumping homeless patients in downtown Los Angeles, including one highly publicized case in which a paraplegic man wearing a colostomy bag was found crawling in a gutter near a skid row park in February.

When will civil dumping become criminal dumping? And what about EMTALA?

Shrink Wrap Up Gifts

Psychiatrists Top List in Drug Maker Gifts | NYT | 6.27.07

As states begin to require that drug companies disclose their payments to doctors for lectures and other services, a pattern has emerged: psychiatrists earn more money from drug makers than doctors in any other specialty.

TANSTAAFL

Nonlocality Rules

The Locality Rule and the Physician’s Dilemma | JAMA | 6.20.07

The purpose of medical malpractice law is to protect patients from substandard medical care and to compensate them for injuries sustained as a result of substandard care. Each medical malpractice case serves an additional function by further delineating the medical care that is legally acceptable in a particular field.

Although medical school training, medical licensing requirements, and board certification requirements are based on national standards, many states rely on local practice standards to determine the applicable standard of care in medical malpractice lawsuits. Jurisdictions that maintain local practice standards may inhibit the incorporation of scientific progress into practice standards. In addition, adherence to the locality rule can create uncertainty for physicians when they must choose between following local practice standards and national, evidence-based standards for care.

With apologies to Einstein, the medical-equivalent of the locality priniciple is being replaced by a nonlocality equivalent—well described in the article cited above. An excellent read. When most aspects of healthcare are regulated and paid for on a national level is it unreasonable to hold the providers of that care to anything less than national standards of care? Is the medical locality rule anything more than the residual vestige of non-specialization and non-board-certification in medicine. Specialization and certification seem to be the professional adoption and endorsement of a nonlocality rule.

Retail Protectionism

Docs want AMA to fight retail clinics | Chicago Tribune | 6.24.07

The American Medical Association should call for a ban of in-store clinics being opened by retail giants like Wal-Mart Stores Inc. and Walgreen Co., several doctor groups urged at the national medical association group’s annual meeting in Chicago today.

Most retailers such as Walgreens do not treat patients under 18 months old. But pediatric groups testified at the AMA that that is still too young. One doctor said pediatric care is too complex for nurse practitioners and think retailers should increase the age limit to three years or even older.

Ah, the irony—the nurse practitioner is just right in the pediatrician’s office… It’s good to see the AMA act as a guild again. Will the Wal-somethings wins? Can “traditional medicine” show they have more favorable cost and outcome?

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