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Nearly everyone knows by now that the high cost of medical malpractice insurance remains a significant problem for Florida’s health care providers. And strategies for fixing the malpractice conundrum abound. However, none of these approaches, including recent tort reforms that I voted for and which passed the Legislature in 2004 have been the silver bullet that providers are seeking to bring malpractice costs in line with those of other states.

Bringing down malpractice rates is going to require a multi-faceted approach – one in which providers can reduce their exposure to litigation while also improving the quality of patient care.

In the hospital industry, an excellent example of this is the growing use of innovative computer software which generates comprehensive patient instructions for discharges from the emergency department (ED). Using such patient education instructions has a variety of benefits. First, it improves the quality of care because patients and caregivers leave the ED with comprehensive information on the patient’s condition, the treatment approach, and what should be done if the patient’s condition changes. Second, providing these instructions reduces the liability exposure for the hospital, ED physician and any of the providers who cared for the patient during the visit. When patients receive detailed, written instructions at the time of discharge from the ED, demonstrating culpability on the part of the health care providers is much more difficult. If the patient’s symptoms worsen but they fail to take personal responsibility and follow the detailed follow-up instructions given at discharge, the hospital and all providers are protected. Third, some electronic systems providing discharge instructions also assist with quality control activities. This is accomplished by prompting the physician to ask the patient about allergies, pre-existing medical conditions and other possible medical problems. This process helps prevent medical errors that can lead to adverse patient outcomes and ultimately lawsuits.

Finally, some discharge instruction systems also streamline work for the hospital staff and ED physicians by writing prescriptions and recording critical patient information. Physicians and/or ED staff also benefit from not having to write out discharge instructions for each patient. In hospitals where sophisticated electronic discharge instruction systems are being utilized, the physicians and ED staff have come to value the assistance and realized time savings.

Some of the early software automation solutions still require that patient information be relayed to nursing staff by the physicians for input to the system. Newly developed, user-friendly systems have demonstrated their efficient use of time and encourage broader physician adoption. This improves patient care and can reduce the chances of medical errors due to miscommunication during the patient documentation process. In fact, ED’s with the newer systems have found that they rapidly become an integral part of the physician-patient encounter.

A number of Florida hospitals are now utilizing electronic discharge instruction systems within their EDs. Examples include Mt. Sinai Hospital, Aventura Hospital and Northwest Medical Center. If all Florida Hospitals adopted similar systems, it would go a long way toward both improving patient care and reducing malpractice exposure.

The use of electronic patient discharge instructions in hospital EDs is just one example of the many ways providers can take a proactive approach to improving care, reducing their malpractice risks and, ultimately, their malpractice premiums. While much uncertainty still remains about the future landscape of malpractice litigation, providers can make a difference today by adopting innovative technology solutions to help control spiraling malpractice costs. Provider initiated approaches to reducing malpractice premiums can be extremely effective in reducing risk and improving patient care if enough providers can be persuaded to pursue this strategy before its too late.