Healthcare practices generate and maintain many different types of records, including patient health records and business records. These records help practices maintain critical information and deliver quality services and care.
Read moreThe patient, a 50-year-old male who was morbidly obese, presented for surgery that required him to be placed in a "jackknife" position (which is known to be risky for obese patients). The surgeon did not perform a medical or cardiac evaluation on the patient prior to the surgery, nor did he obtain an evaluation from the patient's primary care provider.
Read moreA patient who had undergone radiation therapy for cancer of the soft palate presented to his general dentist for routine care. Because of severe xerostomia, the dentist and patient were unable to control the patient's caries.
Read moreInadequate health literacy is a serious concern in healthcare. Research shows that only a small percentage of adults have proficient health literacy skills, and almost 9 out of 10 adults have difficulty using the everyday health information that is routinely available in healthcare facilities.
Read moreA doctor on call for his group practice received an after-hours call from a male patient in his sixties. The patient was complaining of weakness and reported that he had started a new blood pressure pill (hydrochlorothiazide) 3 days earlier. He also reported taking lisinopril daily for more than a year.
Read moreIn this case, a primary care provider prescribed an antibiotic to a patient without reviewing the patient's chart to confirm any existing allergies. The chart contained documentation of an allergy to a certain class of antibiotics.
Read moreClinical systems failures, a contributing factor in family medicine claims, involve breakdowns in office systems and procedures, namely tracking and follow-up systems. Technical issues — such as problems with system interfaces, user errors, software or hardware glitches, and technology failures — also can play a role in clinical system failures.
Read moreModern medicine offers healthcare providers an impressive cadre of diagnostic tools and techniques, including a multitude of different laboratory tests. When lab studies produce abnormal results, investigating the etiology to determine an appropriate explanation is essential. This case illustrates what can happen when a healthcare provider abandons an investigation before a satisfactory explanation is established.
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