EPtalk by Dr. Jayne 6/18/20

More than 100 professional groups are lobbying Congress to create a safe harbor for COVID-19-related litigation. They are advocating protections against bad-faith legal action for primary care practices and physicians. The Coronavirus Provider Protection Act (HR 7059) would provide liability protection for services that are provided during the COVID-19 public health emergency period and for a reasonable time after the emergency declaration ends. It specifically notes issues around services that are provided or withheld in situations that may be beyond the control of physicians and facilities (e.g., following government guidelines, directors, lack of resources) due to COVID-19.

The threat of lawsuits hangs constantly over physicians. I’ve seen the toll it causes, both financially and emotionally, even if a case is dismissed. Some cases are filed well after the care was delivered, and we know that over the last six months, there has been quite a bit of care delivered that doesn’t follow published guidelines for a variety of reasons (including lack of guidelines, lack of appropriate personal protective equipment, lack of medical equipment, etc.)

Although some states have passed protections, it would be good to have a national standard, especially for providers who practice across state lines. There is also plenty of lobbying for protections in other industries, where workers might claim that their employers didn’t protect them adequately from the pandemic or that they were injured as a result. I see the waters becoming muddied rapidly and wouldn’t give the House bill good odds for passage. I would, however, give good odds on the US legal system becoming more entertaining if attorneys and judges started wearing wigs.

Since most of my summer fun has been canceled, I’ve used the time to wade through scores of emails that I intended to answer and were pushed down the inbox by the pandemic. I had missed the announcement of the newest tools from Athenahealth’s Epocrates division, one of which delivers consensus guidelines on drug therapies. The main data table includes not only the recommending bodies, but also the date of last update in a clean format, which is great for those who don’t want to try to sort out the status of multiple recommendations on a daily basis. There’s also a tool for drug therapy trial updates and a great listing of COVID-19 resources, including key points about clinical conditions that can be related to or mistaken for COVID-19.

As a consultant, I’m getting a little twitchy about the fact that I’ve spent three months in the same city without any travel. I’d love to get back on the road, spending time in other parts of the country and meeting people, but I’m not sure those days are ever coming back.

As much as I miss travel, I don’t miss being in a corporate office setting every day. As people go back to work, the CDC has recommended significant changes to US office settings. Recommendations to those returning to office jobs include temperature / symptom checks, distancing of desks (with plastic shields where spacing them out isn’t possible), and face coverings. All those organizations that spent money tearing out cubes and individual offices in favor of open-plan concepts are probably kicking themselves as they try to bring people back.

In a slap to the environment, CDC is recommending avoidance of mass transit or carpools in favor of solo transportation. Employee perks like communal coffee machines and snack stations are out as well, in favor of prepackaged, single-serve products. Not surprisingly, some companies are deciding that it’s better to keep workers remote and cut their office overhead. Even when I was in a corporate role, I was more productive on my “work from home” days due to the lack of interruptions and ability to frequently relax my brain with a distraction, even if it was moving laundry from the washer to the dryer between conference calls. We’ll have to see what productivity looks like over the long term.

It’s been a while since I’ve been up close and personal with concerns about my facility having Certified EHR Technology, so I enjoyed reading this recent ONC blog about the ongoing certification process. The 21st Century Cures Act requires the Department of Health and Human Services to establish Conditions and Maintenance of Certification requirements for the ONC Health IT Certification Program. There are seven Conditions of Certification that vendors will have to meet, along with ongoing Maintenance of Certification requirements. As physicians who have dealt with our own Maintenance of Certification pains, welcome to the club.

As tiresome as I found the Information Blocking requirement to be (everyone talks about it, no one does anything about it), I was intrigued by the Communications requirement. It prevents health IT developers from restricting or prohibiting communications about usability, interoperability, and security of certified health IT modules. I’m sure some vendors will continue to apply plenty of pressure to prevent such discussions, but would love to see some clients come clean about how awful their technology really is before others buy the same tired software.

Those who know me going way back know that I initially dreamed of being not just a doctor, but the first doctor on a long-term space station assignment. Needless to say, that didn’t work out (much to my parents’ relief, I’m sure), but I still enjoy keeping track of what goes on in the next frontier. I enjoyed the recent GlobalMed blog talking about the role of telemedicine in space exploration. It included discussion of the similarities between space travel and research in undersea environments and the need to to use data-driven approaches and technology to solve clinical problems when humans are hundreds of miles above the earth’s surface. If you’ve ever seen the story of the Antarctic explorer who performed his own appendectomy, it gives new meaning to crisis standards of care.

There is so much we have to learn about our potential to live and work in space and the role of technology in making it happen. For instance, we’re just figuring out how to bake chocolate chip cookies in orbit, which would definitely be on my wish list.

What did you want to be when you grew up? How close did you get? Leave a comment or email me.

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