Faxing should be malpractice
As you undoubtedly know by now, I am now officially all about patient safety. (Thanks, by the way, for all the support in the wake of my father’s untimely death.) That’s why I was so upset to read a friend’s recent Facebook status update: “So I discovered the real reason why I was in the hospital last week (and not generally feeling well for the past 4.5 months). My doctor’s office faxed a prescription to my mail order pharmacy that was 2x the dose I was expecting.”
In case anyone has forgotten, fax is technology from the late 1980s and early ’90s. It is now 2012. I cannot remember the last time someone asked me if I had a fax number. Yet, inexplicably, this obsolete means of transmitting low-res images—images, not computable data—remains perfectly acceptable in healthcare.
Here’s a radical proposal: medical societies and state medical pharmacy boards should prohibit the use of faxes. Medical errors related to faxed documents should be considered malpractice. Period.
KILL THE FAX IN HEALTHCARE!
Well, yeah, I mean I agree, but….
The problem was that the fax contained the wrong content, not that the fax was misread… so isn’t this shooting the messanger?
As Grahame said… there are good reasons to eliminate FAX, but this example isn’t one of them. An errant prescription is malpractice in what ever format transmitted.
I suspect the error was on the pharmacy side. E-prescribing eliminates the need for data entry at the pharmacy, but the doctor created the problem by not following what should be best practices. Fax is not a best practice.
The fax was manual? Surely not? *Manual* faxing is malpractice.
It’s all well and good to express opinions that something is “malpractice” but that isn’t what flies in a court of law. Manual faxing is NOT malpractice in an of itself. The courts do NOT go by “best practice” when determining a malpractice but rather by what is the “standard of care” and that standard today is still faxing, for better or worse. That doesn’t mean the provider can ignore what is proper dosing for a patient. Doesn’t mean he doesn’t have to write clearly so as to avoid misinterpretation by the pharmacist. It also doesn’t mean the pharmacist is off the hook if the prescription dose seems inappropriate or dangerous. They have an obligation to question the doctor if those conditions apply. Anyway, the HIE movement is intended to remedy this use of old technology.
My question for you, Joe, is why is it still considered a standard of care?
Until we have a universal EHR, there will always be systems that don’t link to each other. Faxing may be old tech, but it still works and is more efficient that the US Mail, which is even older ‘tech’. That would be the only other option if you gave up faxing in many cases.
[…] the way, my recent, controversial post arguing that faxing should be considered malpractice isn’t a new thought I’ve had. I just rediscovered my January 2011 commentary in […]
Are you expecting technology to save providers from their own mistakes?
We have had e-Rx for almost 2 years. We have learned that it does not eliminate Rx errors. It just replaces the old types of errors with new ones.
As the saying goes, “garbage in, garbage out”…
Mike, GIGO is right, for sure. I don’t expect technology to save providers from mistakes, but this mistake apparently happened on the pharmacy side and from not having the best available technology. It would not have happened with e-Rx tied to proper clinical decision support — or simply verified by the MD before sending so the pharmacy wouldn’t have had to enter the data on its end. The garbage that went in most likely was the result of a transcribing error. The pharmacy should not have had to enter the data in the first place.
I agree that faxing medical info, or any info for that matter, should be stopped. Faxes often sit on the machine for hours letting anyone passing by read your info. Plus there is that ugly, smudgy thing……….