“It is imperative that we obtain the diagnosis and treatment outcomes of our patients, or else good treatment decisions will mean no more than the bad treatment decisions, and the ignorant medics will remain ignorant”
What do I mean by that?
- Many hospital systems have decided that it is a HIPAA violation to provide patient outcomes, and diagnosis’ to prehospital agencies.
- Without this information, there is no way to provide information about how a paramedic’s treatment may have benefited or harmed a patient.
Are the hospital systems right?
The simple answer is NO.
As part of a QA/QI process, all information may be disclosed from the receiving hospital to the transporting agency. Under the QA/QI umbrella, HIPAA has no baring. Furthermore, the treating physician for that patient is, initially the medical director for that transporting agency. If one physician transfers a patient to another physician, they are more than entitled to that patient information. There is no difference between a physician in a hospital whom transfers out a patient, and a medical director whom oversees a paramedic. THEY ARE BOTH THE TREATING PHYSICIANS. They both deserve the right to know what happened to that patient. The medical director can then use that information for the QA process however he wishes.
What is the benefit of having this outcome information?
- Imagine ignorantly treating the same symptoms the wrong way. Information about your patient’s outcome could inform you of this mis-treatment, and you could then make the appropriate changes.
- Now imagine an entire EMS agency treating the same types of patients the wrong way. Outcome data could show trends in beneficial or detrimental treatment outcomes, and the appropriate changes could then be made.
So why the reluctance?
- The first reason is ignorance – the hospitals just don’t know that this information is just as much ours, as it is theirs.
- The overwhelming reason is presumably the reluctance to display their own poor performance. Hospitals will keep their save rates, door-to-balloon times, botched surgeries, and other information that may alter the money they make or fork out, under lock and key if they can.
So what can we do?
I am leaving this answer up to my readers. Any attorneys out there who have taken this on? Any supervisors or managers who have sat at the table and come up with a plan of action? LET US KNOW.
Please comment on this, and get the discussion going…