DEA Extends Covid-19 Telehealth Prescribing Flexibilities for Another Year.
The Drug Enforcement Administration (DEA) in concert with the Department of Health and Human Services (HHS) is issuing a third extension of telemedicine flexibilities for the prescribing of controlled medications, through December 31, 2025. A DEA-registered practitioner can prescribe a schedule II-V controlled substance to a patient using telemedicine without the need for an in-person medical evaluation, as long as the prescription(s) are for a legitimate medical need, and within the course and scope of the prescriber’s medical practice. As you may recall, the DEA extended the COVID flexibilities through 2024 while it worked on a revised set of rules, which were to...
Incomplete Patient Understanding of Risks Complicates Surgery
This case study was made available to MIEC through our partnership with CRICO. It was written by Kathy Dwyer, MSN, RN, CRICO Description A patient undergoing elective surgery suffered severe anoxic brain injury due to complications from a pre-existing condition. Key Lessons Elective surgery should not proceed when the team does not have a thorough understanding of the patient’s medical history. A patient's memory and understanding of complex clinical facts is not a substitute for reviewing the medical record or consulting with clinical colleagues. Clinical Sequence A 56-year-old female met with the anesthesia resident 10 days before she was scheduled...
Gaps in Clinical Workup Lead to Young Patient’s Missed Colorectal Cancer
This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description A 33-year-old woman was diagnosed with colon cancer more than two years after her initial complaint of rectal bleeding. Key Lessons Gaps in clinical workup can lead to flaws in medical decision-making. Sub-optimal surgical/invasive procedures can lead to missed diagnoses. Clinical Sequence A 31 -year-old woman with no significant medical history complained of rectal bleeding to her primary care physician, a cardiologist. At this visit, she also described hard stools with hematochezia and possibly hemorrhoids. The cardiologist performed a...
This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description Six days after his initial visit to Urgent Care for ear pain and facial paralysis—and after three CT scans—a 28-year-old man was diagnosed with bacterial meningitis. Key Lessons A patient’s return for care with worsening symptoms should trigger a diagnostic questioning protocol Fragmented patient care increases the need for concurrent communication among providers Clinical Sequence A 28-year-old man presented to Urgent Care with complaints of right ear pain and right-sided facial paralysis. At this visit, impacted ear wax was...
DEA Likely to Further Extend Flexibilities on Controlled Substances and Telehealth Prescribing Beyond 2024
During the first year of the COVID-19 pandemic, the provision of medical care through telehealth increased by 154%, and much of that increase occurred in behavioral health. This trend, combined with COVID risk mitigation strategies and temporary flexibilities in licensure and regulatory requirements, resulted in substantial growth in virtual-only medical practices. In the field of behavioral health, temporary flexibilities allowing telehealth-only prescribing of controlled substances has allowed these practices to flourish by allowing them to treat a full spectrum of conditions through remote-only care. However, as the COVID pandemic ended, an important question arose as to whether telehealth-only prescribing of...
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