Knowledge Library

Safety Nets for Safer Care

A 33-year-old woman went to the Emergency Department (ED) for abdominal pain and intermittent rectal bleeding. The attending physician ordered a colonoscopy, but it was never completed. The patient was diagnosed with colon cancer two years after her initial ED visit, and she passed away within a year. No one will ever know if having that initial follow-up would have changed her outcome, but an earlier diagnosis might have offered a better chance for survival. Preventing patients from falling through the cracks in the system is a constant challenge, and some health care organizations have turned to ambulatory safety nets...

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Revised Regulation: DEA-Registered Pharmacies can Transfer Electronic Prescriptions at a Patient’s Request

On September 1st, 2023, the DEA released a revised regulation allowing pharmacies to transfer electronic prescriptions for controlled substances to another pharmacy at the patient's request. This can be very helpful given some of the medication shortages patients have experienced over the last year. The new rule allows for a one-time transfer of electronic prescriptions for Schedule II-V controlled substances to another pharmacy without having to involve the prescribing provider. Patients will no longer need to call their provider and ask for the prescription to be sent to a different pharmacy. Any authorized refills included on a prescription for a...

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Update on EMTALA protections for medically necessary abortions in Idaho

There have been several recent developments in Idaho with regard to EMTALA protections for medically necessary abortions. First, on September 28th the Ninth Circuit Court of Appeals removed the injunction that allowed physicians in Idaho to perform abortion as part of medically necessary stabilizing care under the Emergency Medicine and Active Labor Act (EMTALA). As previously reported, after Idaho prohibited abortion in August 2022, the federal government sued Idaho under the premise that EMTALA preempted state law in cases of emergency.  The federal district court issued a preliminary injunction in that case; the injunction essentially created a requirement for physicians...

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Hawaii Wildfires

The recent wildfires in Hawaii, now the deadliest wildfire event in over a century, are straining local healthcare resources as physicians and other providers care for patients who were directly injured in the fires and/or emotionally traumatized by the disaster, as well as displaced residents who need ongoing medical care.  Several local clinics, physician offices, and other healthcare facilities were either destroyed in the fires or closed due to lack of access.  As the state mobilizes to reinforce local hospitals and providers, concerns about rising COVID-19 cases in Hawaii further complicate efforts to preserve healthcare capacity in the state. Since...

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Lawsuits are Not Always Over When the Verdict Comes In

Clinician stress is well-documented. Even before the pandemic brought the double whammy of reduced staffing levels and increased patient care burdens, the ever-growing demands from electronic medical records, patient satisfaction surveys, and health insurance pre-authorizations contributed to burnout. However, one stress factor that isn’t usually considered is litigation. During a lawsuit, clinicians are likely to feel isolated, in large part because they are discouraged from discussing their case with their peers. When combined with remorse and self-doubt, as well as immersion in new and unfamiliar legal terrain, clinicians may experience sleepless nights and an inability to focus. Relationships can become...

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