Malpractice Claims Involving Electronic Health Records on the Rise

October 16, 2017 by matray

Malpractice claims in which the use of electronic health records (EHRs) contributed to patient injury have increased continuously during the past decade, according to a study released today by The Doctors Company.
The study reveals that claims in which EHRs are a factor grew from just two between 2007 and 2010 to 161 from 2011 through December 2016. Typically, the EHR is a contributing factor in a claim, rather than the primary cause, according to David B. Troxel, MD, study author and medical director at The Doctors Company. It's the second study of its kind by The Doctors Company, which recognized early on that despite the potential of EHRs to advance the practice of good medicine and patient safety, there would be unanticipated consequences from this rapidly adopted new technology. The latest research compares 66 claims made from July 2014 through December 2016 with the results of the first study of 97 claims from 2007 through June 2014. Compared with the earlier research, the new study shows:
  • System factors that contributed to claims — such as technology and design issues, lack of integration of hospital EHR systems, and failure or lack of alerts and alarms — increased 8 percent.
  • User factors — such as copy-and-paste errors, data entry errors, and alert fatigue — decreased 6 percent.
  • More EHR-related claim events are occurring in patient rooms and fewer are occurring in hospital clinics/doctors' offices, ambulatory/day surgery centers, labor and delivery as well as emergency rooms. However, hospital clinics/doctors' offices remain the top location for these events.
  • Internal medicine, hospital medicine and cardiology showed marked decreases among specialties involved in claims.
  • Family medicine and nursing also showed decreases.
  • Orthopedics, emergency medicine and obstetrics/gynecology showed increases.
"While digitization of medicine has improved patient safety, it also has a dark side—as evidenced by the emergence of new kinds of errors," said Robert M. Wachter, MD, professor and chair, Department of Medicine, University of California, San Francisco. "This study makes an important contribution by chronicling actual errors, such as wrong medications selected from an autopick list, and helps point the way to changes ranging from physician education to EHR software design."

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Medical Liability Monitor’s 2017 Annual Rate Survey Indicates a 1.1 Average Rate Decrease Among Medical Malpractice Insurers Despite Underwriting Challenges

October 4, 2017 by matray

Chicago — According to just-released data from the 2017 Medical Liability Monitor Annual Rate Survey, the medical professional liability (medical malpractice) insurance industry’s collective mature, base-rate premiums experienced an overall average decrease of 1.1 percent from last year. More specifically, Internal Medicine rates decreased 1.1 percent, General Surgery rates decreased 1 percent and OB/Gyn rates decreased by 1 percent. “The slight average decrease in mature, base-rate medical malpractice insurance premiums marks a continuation of the medical professional liability insurance industry’s historic soft market,” said Michael Matray, editor of Medical Liability Monitor. “What’s interesting is that the market continued to soften at the same time the industry’s combined ratio crept above 100 percent for the first time in a decade. The question is how long can insurers be aggressive with pricing in the face of slipping underwriting results.” For the overwhelming majority (74.2 percent) of insurers participating in this year’s Annual Rate Survey, rates remained flat between 2016 and 2017, very similar to the percentage with no manual change shown between 2015 and 2016 (75.2 percent). The next largest segment of rate change was increases within the 0.1 percent to 9.9 percent (13.3 percent). When reported medical malpractice insurance rates are broken down regionally, the only region reporting an average rate increase is the Northeast region – due to a 12-percent increase in the Pennsylvania PCF surcharge and Maine reporting a 2.5-percent increase. In the South, decreases in Texas and Virginia of 3 percent and 3.6 percent, respectively, and increases in Florida, Georgia and South Carolina of 1.5 percent, 1 percent and 1.8 percent, respectively, combine for an overall decrease for the region of 0.9 percent. The change reported for the Midwest is a 2.1 percent decrease. Kansas, Michigan, Missouri and Ohio all reported decreases around 5 percent. A very slight decrease (0.3 percent) was reported for Illinois due to one carrier reducing the rate for the OB/Gyn specialty. Nebraska and Indiana are each reporting increases of roughly 3 percent, but the increase in Nebraska is driven by an 18 percent increase in the PCF charge. The two states with the largest reported changes are in the West region — Hawaii and Montana — report average decreases of 9 percent and 7.2 percent, respectively. In New Mexico, the PCF surcharge increased by 9.3 percent, while the primary carriers are holding rates flat, driving an increase for the state of about 1.3 percent.

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Medical Liability Monitor is the only independent publication reporting exclusively on the medical professional liability insurance and risk management industries. The monthly newsletter, founded in 1975, has conducted the Annual Rate Survey since 1991. To order the Annual Rate Survey or to subscribe to the monthly newsletter, visit www.medicalliabilitymonitor.com or call 312-944-7900.        

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MedPro Group Announces Acquisition of Leading UK Provider of Contractual Medical Indemnity Insurance

October 3, 2017 by matray

Berkshire Hathaway International Insurance Limited (BHIIL) and MedPro Group Inc. (MedPro) announced today the addition of Premium Medical Protection Ltd. (PMP) to the Berkshire Hathaway group of healthcare liability companies. BHIIL, MedPro and PMP have been working together since 2014 to deliver contractual medical indemnity insurance as well as patient safety and risk management solutions to private practice consultants and surgeons in the United Kingdom. Subject to regulatory approvals, this transaction is expected to close by year-end. “PMP was created nearly a decade ago to provide UK consultants and surgeons with the best contractual medical indemnity insurance and patient safety solutions available,” said Juliet Bentley, PMP’s founder and CEO. “Our combination of top customer service, winning defense and leading contractual insurance protections have resulted in delighted customers and sustained PMP growth. Joining BHIIL/MedPro Group in the Berkshire Hathaway group of companies offering healthcare liability solutions continues our mission and allows us to further expand our capabilities and services to even more healthcare providers throughout the UK.” With offices in Leamington Spa, Glasgow and London, PMP and its BHIIL/MedPro partners serve nearly 2,000 private practice consultants and surgeons throughout the UK. Ms. Bentley will remain as president, and its employees and operations will continue as is. “We are delighted to be able to work even more closely with PMP, and – with this acquisition – further highlight and strengthen the Group’s commitment to the UK medical malpractice market,” said John Bartlett, BHIIL/MedPro International vice president. “The Group will be a great home for PMP and its dedicated employees.”

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The Doctors Company Hires New Head of Underwriting

October 3, 2017 by matray

The Doctors Company announced today the selection of Crystal R. Brown as senior vice president of underwriting, effective immediately. In her new role, Brown leads the company's underwriting operations nationally, reporting directly to Bill Fleming, TDC's chief operating officer. Brown most recently served as healthcare zone leader for CNA Insurance in Chicago. At CNA, she oversaw a team of underwriting professionals at 10 branch offices who focused on the healthcare segment, including community and specialty hospitals, academic medical facilities, allied healthcare, accountable care organizations, large medical and academic groups, skilled nursing homes, assisted living centers, independent living facilities, life plan communities and life science companies. “We are very excited to have Crystal join The Doctors Company’s leadership team,” Fleming said. “With her broad experience with many types of healthcare organizations, she brings a deep understanding of the ever-changing healthcare environment and expertise in developing solutions for technically complex healthcare accounts across the enterprise. She will be a great asset in our work to provide expert guidance, resources, and coverage to our members no matter how they practice.” Brown has more than 25 years of underwriting experience. She held several roles at CNA, including assistant vice president, underwriting director and senior underwriter. She also previously worked as a healthcare specialist for Continental Insurance Company in New York prior to the merger with CNA. She is a graduate of the Advanced Leadership Program at Kellogg School of Management in Chicago, and she earned an MPA in Health Services Management from New York University as well as a bachelor’s degree in English from Amherst College in Amherst, Massachusetts. “I am honored to have been selected by The Doctors Company to lead, collaborate with and motivate the teams and regions to grow our membership and expand our capabilities,” Brown said. “I fully support and am encouraged by our mission to advance, protect and reward the practice of good medicine. I look forward to working on unique solutions for our members.”

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Demotech Upgrades Conventus Inter-Insurance Exchange FSR to “A”

October 2, 2017 by matray

Conventus Inter-Insurance Exchange, a New Jersey medical malpractice insurer, announced that the Demotech Financial Stability Rating (FSR) assigned to it has been upgraded to A (A Double Prime), Unsurpassed. This is Demotech’s highest FSR, assigned to insurers who possess exceptional financial stability related to maintaining positive surplus for policyholders, liquidity of invested assets, an acceptable level of financial leverage, reasonable loss and loss adjustment expense reserves (L&LAE) and realistic pricing.

“We are extremely gratified to have been assigned Demotech’s highest Financial Stability Rating,” said Lyn Winters, Conventus president. “The Conventus promise to its member owners is that we will manage the company responsibly, and in the best interests of our physicians, so that we will be there for them now and in the future. This rating upgrade is further confirmation that Conventus is extremely strong financially and solidly positioned for continued growth and long-term success.”

Launched in December 2002, Conventus now insures almost 1,200 physician owners with a total surplus of more than $41 million. Conventus is also celebrating its eighth consecutive year of returning profit to its physician member owners through the Conventus Owner Benefit Plan, rewarding almost $13 million in dividends and capital returns in that time.

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