Patient harm Senate Hearings 2014

Thursday, July 17 2014, 10:00 AM

Subcommittee Hearing - More Than 1,000 Preventable Deaths a Day Is Too Many: The Need to Improve Patient Safety

Six experts testify in front of subcommittee with their heart felt convictions.

End of this short video, Senator Bernie Sanders asks, How come this is not in the newspapers every single day?

Danny Long goes to Washington
As a representative of the patient harm population, I was privileged to sit in on the hearings on 7/17/14.  This is my take on what I heard, and did not hear or see, AND what I learned in the next few days.

First, I must say sadly I did not have a chance to visit with all of those giving testimony, but I had the privilege to visit with two of the folks, John James, PhD prior to the hearings, as well as say hello to Peter Pronovost, MD, PhD. Their message during the hearings was true to their long standing convictions.
Having dinner with the award winning writer Marshall Allen from Propublica the night before and telling how we each became involved with the whole patient harm story was enlightening as well as enjoyable.  Credit where credit is due, Marshall was one of the very few writer in attendance, and promptly posted his article on the Propublica titled "We are still not tracking patient harm"  

I will take my friend Marshall's article a step further, to point out much of what is historically come out of the medical community simply is not credible to start with. As you will see this truth was glaring in the opening remarks by Senator Bernie Sanders..
BUT there IS evidence of of cries for help from behind the wall.2013 and so far 2014 has yielded much of what is behind the wall from insiders and some of this can be attributed to the Propublica work.



OK, now on with my take on events. All during the hearings the questions focused on what do we know?   While the cost of waste inside the medical industry (as much as the entire Pentagon Budget every year) little more is known simply because "very little medical information is credible" . Money is the only verifiable audit trail.  Documentation of events inside medical care, not so much.

I walked in very interested to see what Senate Committee members were NOT present. It was enlightening to see of the twenty two committee members, only three felt the number three cause of death while demanding 17% of the America's Gross National Product was important enough to even show up. So with that I give a big shout out to Bernard Sanders (I) (VT)   Elizabeth Warren (MA) and Sheldon Whitehouse (RI)

The other glaring fact was the absence of mainstream media!

But then I again, I would rather be in a room with three people who have hear the cries to end the needless suffering, than be in a room with twenty two people trying to derail the hearings with distractions, and miss information.  So it was a good thing.

The opening statements of the hearings set the tone: Once the hearings started, It was quickly apparent Bernie Sanders was being polite, but not happy with the state of medical information or care in America.

But I quickly moved to the edge of my seat concerning his opening statements quoting the 2010 Center for Disease Control findings about the #1 cause is Heart Disease at 597,000 a year.
HUGE problem here right away, the Center for Disease Control also learned in 2010 that often medical residents are told to falsify death certificates as much as nearly 50% of the time to "list" heart disease as the cause of death when in fact resident know it is not true!   Heart disease is commonly listed as cause of death in hospitals when Septic Shock is the  "actual" cause of death.
So right off the bat, Bernie and the other two Senators are trying to get to the bottom of the problem with known cooked books.

This blatant false information is a recurring concern of mine now SHOWS UP HERE in the Senate hearings on OPENING REMARKS!  
Tweet
This flies against human logic yet again, the federal HIPAA law includes 1035 False Statements in Healthcare Matters.
As you see below the 1035 federal law is VERY clear about the penalty for falsifying anything related to "The delivery of, OR payment or payment for health care benefits, items, or services"

"Whoever, in any matter involving a health care benefit program, knowingly and willfully falsifies, conceals, or covers up by any trick, scheme, or device a material fact; or makes any materially false, fictitious, or fraudulent statements or representations, or makes or uses any materially false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry, in connection with the delivery of or payment for health care benefits, items, or services, shall be fined under this title or imprisoned not more than 5 years, or both".  Yet even the CDC knowingly hand over bogus death rate data to Senate committee to use as "reliable data"??? 



What about electronic records? Are hospitals deleting the audit logs to hide tampering with electronic records (meta data)?
You guessed it! This was part of what the Office of Inspector General in the VA scandal found. Meta data is being deleted at an alarming rate.
“Considering the conflict of interest a hospital has regarding hiding potential fraud or malpractice that could cost them millions of dollars, a capability to ‘delete the contents of their internal audit logs whenever they’d like and to edit audit trails… is simply alarming,” declared Scot M. Silverstein, M.D., Assistant Professor of in Health Informatics and Information Technology at Drexel University’s Institute for Healthcare Informatics.

Exactly what is audit log?
An audit log is a record of how information is entered, revised, or deleted in an EHR. In its program to reward physicians for "meaningful use" of EHRs, HHS specifies what an audit log should do in software it deems acceptable. According to the government's 2014 standards for meaningful use, an EHR's audit log must:

1. capture the date and time of a change or use of the record;
2. identify the patient;
3. identify the EHR user;
4. identify the type of action, such as printing or copying data, submitting data queries, or entering, revising, or deleting data; and
5. identify the patient data being accessed.

So you see, if a medical record is to be proved credible, you need to know who, what, when, where, and how it was created in its current form.  Deleting audit logs (meta data) is never needed unless you want to hide THE FACT THE RECORD WAS ALTERED!. As simple as that.





Yet recently there is signs of hope from behind the wall of corruption, often in medical studies exposing the ugly truth. 2014 research scientist Vincent Liu, MD, an intensivist at Kaiser Permanente in Santa Clara, Calif., now admits that depending on the definition of sepsis, 34.7% to 52% of deaths in the Healthcare... He went on to admit, "Sepsis mortality in hospital is an underestimated, under-recognized phenomenon in hospitals due to problems in hospital hygiene and due to an increasingly older and frailer patient population,"







But wait, surly nearly half of medical residents are not willingly falsifying patient records are they?  Healthcare/Corporate Bullies: 
According to Drew Neckar In 2008 the leading accreditor of healthcare organizations, the Joint Commission, recognized that "intimidating and disruptive behaviors can foster medical errors" and other conditions detrimental to overall patient care. This was the focus of its Sentinel Event Alert "Behaviors that undermine a culture of safety," which reported "40 percent of clinicians have kept quiet or remained passive during patient care events rather than question a known intimidator."
"You will do what your told or else"




According to the 2013 Johns Hopkins study: Misdiagnosing patients or making diagnostic errors is one of the most costly and dangerous mistakes made by doctors in the U.S., resulting in up to 160,000 deaths per year. "This is more evidence that diagnostic errors could easily be the biggest patient safety and medical malpractice problem in the United States. There's a lot more harm associated with diagnostic errors than we imagined.”
This 160,000 is much higher than all of the provider liability payments for any given year, yet where is this in the patient's medical records?  No where... Federal law 1035?

See video: This corporate business model lends itself to the all too common corporate bullying/psychopath rise to power. We can see this recently studied by Clive. He is a Professor of Leadership and Organizational Behavior at Middlesex University in England. For the past seven years, he has studied the evidence and effects of toxic leadership, and in particular the influence of the presence of corporate psychopaths on various workplace outcomes.











Another symptom of this toxic environment of medical schools is provider Drug addiction and drug diversion.link
Hi. I'm Dr. Joe Perz, a healthcare epidemiologist at the Centers for Disease Control and Prevention (CDC). I'm pleased to be speaking with you today as part of the CDC Expert Video Commentary series on Medscape. I will be addressing the issue of drug diversion. It can be defined as any act or deviation that removes a prescription drug from its intended path from the manufacturer to the patient. Prescription opioid addiction, which has reached epidemic  in some areas of the United States, is a major driver of drug diversion.
proportions
This video commentary will focus on diversion involving healthcare personnel who steal controlled substances for their personal use. Under these circumstances, patient harm can take many forms, including substandard care delivered by an impaired provider, denial of appropriate therapy or pain control, and even infection risks stemming from tampering with injectable drugs. Healthcare professionals who divert drugs risk losing their licenses, credentials, and employment; they even risk losing their lives if they overdose. Consequences may also include litigation or imprisonment.




More effects of the toxic environment of medical school.
2010: For several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population — 40 percent higher for male doctors and a staggering 130 percent higher for female doctors. While research has traced the beginning of this tragic difference to the years spent in medical school, the contributing factors remain murky. Students enter medical school with mental health profiles similar to those of their peers but end up experiencing depression, burnout and other mental illnesses at higher rates.

It is clear, the Senate hearing were lacking in transparency of the toxic environment of not only medical schools, but hospitals.

Intimidation, and desensitizing residents to the sanctity of human life, even their own.

















 "Hide No Harm Act of 2014, a bill that would make it a crime for a corporate officer to knowingly conceal the fact that a corporate action or product poses a danger of death or serious physical injury to consumers and workers. The bill, which would create punishments of up to five years in prison and potential fines, would also create a safe harbor from criminal liability in cases where a corporate officer notifies a federal regulatory agency and individuals subject to the danger.




The big advantage is 1035 already exists!
Federal HIPAA law includes 1035 False Statements in Healthcare Matters.  
As you see below the 1035 federal law is VERY clear about the penalty for falsifying anything related to "The delivery of, OR payment or payment for health care benefits, items, or services"

"Whoever, in any matter involving a health care benefit program, knowingly and willfully falsifies, conceals, or covers up by any trick, scheme, or device a material fact; or makes any materially false, fictitious, or fraudulent statements or representations, or makes or uses any materially false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry, in connection with the delivery of or payment for health care benefits, items, or services, shall be fined under this title or imprisoned not more than 5 years, or both".  


Give the young residents a fighting chance to be the very best. End the toxic environment.




Danny Long 7/19/14