Knowledge Library

ONC Final Rule on Information Blocking

Beginning in April 2021, patients will have the right to directly access their electronic health information under a new federal requirement.  On May 1, 2020 the DHS Office of the National Coordinator for Health Information Technology (ONC) issued a Final Rule on Interoperability, Information Blocking, and the ONC Health IT Certification Program (part of the 21st Century Cures Act).  The law is also known informally as the “Open Charts law.” The Final Rule prohibits the practice of “information blocking,” which is defined as any practice which is likely to interfere with access, exchange, or use of electronic health information (EHI)...

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Smartphones and Texting with Patients

Text messaging or SMS (short message service) has become the virtual default method of direct communication in today’s society. As regular mail and even personal emails are increasingly as difficult to find as needles in virtual haystacks, and there is less and less time for telephone calls, individuals who want timely responses are using text messages to communicate- and this expectation is present in healthcare as well. Consider the following statistics: 95% of text messages are read within 3 minutes of being sent. (Forbes) 98% of text messages are read. (Physician Practice News) 91% of US adults 65+ own a...

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Unanticipated Medical Outcomes – Disclosure and Apology

It has been twenty years since the Institute of Medicine report To Err is Human: Building a Safer Health System was released. Pioneers such as the University of Michigan, University of Illinois, the Veteran Affairs Medical Center in Lexington, KY, and the Agency for Healthcare Research and Quality (AHRQ) undertook the challenge to research and develop methods to communicate medical errors and other adverse outcomes to patients and families. Disclosure, apology, and potential resolution present particularly challenging topics in the setting of medical professional liability, where state and federal laws and regulations can impact the scope of communication and the...

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Ketamine – The Next Breakthrough for Depression?

A Modern Epidemic Major Depressive Disorder (MDD) affects an estimated 320 million individuals worldwide (16 million in the U.S. alone), and the incidence of this condition has increased substantially in the last decade. Further challenging psychiatrists, current pharmacologic therapies (MAO inhibitors, tricyclic antidepressants, and SSRIs) are limited by therapeutic lag times of up to weeks or months, and high refractory rates of approximately 30%. Patients with treatment-resistant depression face limited options, such as transcranial magnetic stimulation (r-TMS) or electroconvulsive therapy (ECT), and patients with suicidal ideation may remain at risk while they wait for a newly-prescribed antidepressant to take effect....

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California Informed Consent Supplement

This supplement to our "Informed Consent Revisited" article contains excerpts from California laws related to informed consent, consent by minors and special consents. California physicians who have questions about a specific patient or who require legal advice may call MIEC’s Claims Department in Oakland at 800-227-4527. For general liability questions, physicians and their staff can call MIEC’s Patient Safety & Risk Management Department in Oakland, CA at 800-227-4527. Informed Consent In California, the current law on informed consent is derived largely from the case of Cobbs vs. Grant (1972) 8 Cal.3d 229 in which it was ruled that a physician...

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