By using closed malpractice case data, lawmakers aim to standardize best practices and create benchmarks in medical treatment.
Using Medical Malpractice Litigation For Healthcare Analytics
September 23, 2014
In medicine, the first rule is to do no harm. Unfortunately, patients are injured as a result of medical treatment, or a preventable mishap occurs due to negligence on a doctor’s behalf. Such occurrences can manifest in the form of improper drug administration, botched surgical operations, restraint injuries, mistaken patient identity and so on. Medical malpractice law arose out the need to protect patients against paying for undue medical costs, or to compensate for life changing injuries brought about by improper or negligent treatment. To Err Is Human: Building a Safer System, a study by the Institute of Medicine (IOM), shook up the healthcare system when it estimated that up to 98,000 deaths are caused each year as a result of preventable medical errors. The study not only shed light on the grave statistics on medical malpractice, but also the financial burden such errors were imposing on the healthcare system. According to the study, medical errors also resulted in a loss of trust among patients, perhaps steering them away from treatment of preventable disease, and lowered overall morale within the healthcare ecosystem. While there seems to be widespread agreement on the need to lower healthcare costs associated with medical errors, the way to reach that goal is a subject of contention. A movement among lawmakers suggests that tort reform, aimed at protecting health care providers from expensive litigation, is a justifiable means. However, some argue that such legislative efforts limit the rights of patients because it restricts their ability to file a lawsuit, obtain a jury trial and/or reduces the amount of money awarded to the injured. To many, such measures by lawmakers seek to address the effect and not the root cause.
Using closed malpractice case data
Another measure being explored to combat medical malpractice costs comes in the form of healthcare data derived from closed malpractice cases. Such data is considered highly valuable since medical malpractice cases take exhaustive efforts to explore the specific causes behind medical errors. The process of bringing a malpractice case before a jury requires careful documentation and examination of case data. All medical data leading up to the point in which the alleged error occurred and independent expert witness testimony on behalf of both the aggrieved and the defendant shed light on instances in which medical errors took place. The study by the IOM cited one case in which medical data taken from closed malpractice cases vastly improved patient safety while reducing healthcare costs. The American Society of Anesthesiology (ASA) used a wealth of information from closed malpractices cases and adopted mandatory safety measures. As a result of these safety measures, instances of wrongful death were reduced from one to two deaths for every 10,000 procedures to just one for every 200,000. Another study in the American Journal of Obstetrics & Gynecology cited the use of 200 closed malpractice cases that helped reduce medical errors and successfully implemented procedures resulting in the improvement of child-birth outcomes, including lower maternity and fetal injury rates, lower primary cesarean delivery rates, and reduced rates of legal action. The study maintained that the best way to reduce the cost of litigation and rate of adverse treatment is through procedural standardization, and unambiguous guidelines rather than making “unusual care more defensible.” Pegalis and Bal state in their study of malpractice cases that using closed malpractice cases can be considered superior to peer review. Due to the nature of the medical field, conflicts can arise diluting the efficacy of peer review when the fear of lost referrals or skewed reviews of competitors come into play. Peer review is regarded as an important mechanism in maintaining the autonomy of ethical motivation, one can see how using malpractice case information can provide a more holistic and objective view of a circumstance where a medical error has occurred. Pegalis and Bal’s study concludes that closed malpractice case data is no silver bullet.
A useful resource
The National Practitioner Data Bank (NPDB) was created as a Congressional measure to collect and use data on health care providers. It allows individuals to view statistics and analytical data to gain insights into malpractice cases. The NPDB includes a resource called the Data Analysis tool where users can browse Adverse Action Reports (AAR) and Medical Malpractice Payment Reports (MMPR) submitted on practitioners. While information on this site does not link to specific health practitioners, actionable information may be gained on malpractice lawsuits to aid in the necessary adjustments to reduce medical errors and/or reform tort laws.
While it can be said that healthcare reform still has a long way to go, it has certainly come a long way since the IOM’s study. For instance, preventative medicine has become a key focus among healthcare providers and insurers. Individuals advocating for their own health decrease the risk of entering potentially calamitous medical situations in the first place. That being said, the best approach to a functional medical system is where all interested parties – patients, physicians, insurers, lawyers and lawmakers – participate on behalf greater good, as opposed to greater income. Closed malpractice cases can provide a wealth of information to assist in these efforts by helping to standardize best practices and creating benchmarks, but it is just one piece in a puzzle of a picture of health. Originally posted on healthitanalytics.com by Ron Vatalaro