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Malpractice and Templates

 
 
Malpractice and Templates
 
Curtis E. Harris, M.S., M.D., J.D., Practicing Endocrinologist, Professor of Medical Law University of Oklahoma, Oklahoma City, Oklahoma, and Praxis EMR user.


"PRAXIS EMR has far greater utility and flexibility than a template-driven program. In addition, PRAXIS has another very valuable feature that you may not have considered: that is, enhanced legal protection for the busy practitioner.

Good documentation is critical to properly defend a physician against a malpractice claim. However, it is not only important to record what was done, but also to show the logical progression of thought that leads to a diagnosis or course of action.

PRAXIS requires the physician to record his thinking process, and to refine the logic with each new patient. By focusing on the difference between patients, the record necessarily reflects why one given diagnosis or therapy was chosen over another. This in turn allows the defense attorney to use the record to assert the uniqueness of the patient, and why a particular therapy was chosen for this patient. Since a physician is not held to be a guarantor of a cure or a good result, but instead must choose an acceptable treatment based on the information available to the physician at the time the choice was made, clear documentation of what was known is usually an adequate defense.

There is another related problem that is latent in every template-driven program that is not present in PRAXIS. The templates in other systems are subject to discovery and may be used against the defending physician. Imagine how pleased a plaintiff's attorney would be to find that a physician's entire practice could be reduced to a series of simple statements. Suddenly, the art of medicine is diminished, and the defending physician appears to be a mere technician in the way he practices, forcing all his patients into a single mold. However, since PRAXIS is based on the examination of previous patients, these records are not subject to discovery since they are protected by physician-patient confidentiality.

While the process by which a physician using PRAXIS to enter data is discoverable, that process is little different than what is now done without PRAXIS. While several other systems provide for such things as accurate and legible recording of notes and prescriptions, it is the flexibility and theory behind PRAXIS that will, in the long run, provide the best legal protection for the practicing physician."

 
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