OTHer blogs in this series
As we continue to highlight the array of problems associated with the paper-based informed consent process at the University of Wisconsin Medical Center, we turn our attention towards the issue of disconnected facilities. One of the main causes that led to the incorrect procedure being performed on a patient was their archaic use of a paper-based faxing process. This issue could have easily been prevented with electronically connected systems.
The Problem with Faxing Paper-Based Informed Consents
- If you are capturing patient signatures on paper-based informed consents and you are doing this at an offsite doctor's location that is not on the same electronic medical record system as the hospital, there are many things that can go wrong. The handwriting on the forms could be illegible
- Documents could be faxed to the wrong location
- The form could be put into the fax machine in wrong direction, sending a blank piece of paper
- The form could fall off the fax machine on the other end and get swept into the oblivion.
In our 20 years of healthcare experience, Access eForms has seen these issues and many more arise when faxing paper documents. In this particular case with the University of Wisconsin Medical Center, however, the issue is a little bit more nuanced.
The process worked until...
In this situation with UW Medical Center, the doctor captured the patient’s signature on the informed consent and faxed it over. The document was received by the hospital along with the other documents relative to the procedure and the process of getting documents from point A to point B was successful. However, after the patient left, the doctor’s office called back and requested alterations to the procedure. This change was made in handwriting on the informed consent at the doctor's office and within the doctor’s electronic medical record system, but the revised informed consent was never faxed over to the hospital. So, the correct information resided within the electronic medical record system and on a piece of paper at the doctor's office, but not at the hospital. When the patient arrived at the hospital for their procedure the next day, everybody operated on old information. It was not until after the surgery when the patient was being debriefed in the recovery room that the mistake was realized. Corrective action was necessary, and the patient needed an immediate second surgery to perform the correct procedure.
The importance of connected electronic medical records and patient electronic signature
If the doctor’s office electronic medical record system were the same as or integrated with the hospital’s system, this situation could have been avoided. Furthermore, paper consents still must be scanned in, and these pieces of paper get lost all the time. An electronic medical record system along with patient electronic signature would have prevented this medical disaster.
There have been tremendous advances in connected health care systems, electronic medical records systems, and patient electronic signature. However, acquiring these systems can be expensive, and the level of effort required to implement these systems is a whole other issue. Hospitals still rely heavily on disconnected electronic medical record systems and faxing as a means to get paper forms from point A to point B. Any step that can be taken down the electronic pathway to mitigate these issues could mean one less error that occurs on the operating room table.