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The Way We Were

by Kelly Williams

The University of Washington has one of the finest medical schools in the country. The medical facilities where our medical staff practice include University of Washington Medical Center, Harborview Medical Center, UW Physicians Clinics, Children’s Hospital and Regional Medical Center, Seattle Cancer Care Alliance and many other sites. We are fortunate to have a favorable track record of medical malpractice claims and lawsuits compared to other teaching universities nationwide. However, with over 3,500 medical practitioners within our system, we do have medical malpractice cases to manage. The university’s self-insurance program covers our health care providers for medical malpractice cases, and the Office of Risk Management manages these cases.

As you can imagine, it could be a paper-intensive, time-consuming process to gather information on these cases. But, through sharing of electronic systems, we are improving our efficiency dramatically.

The hospitals have an extensive risk management system that deals with “events,” which are unexpected outcomes of patient care. When events occur they are investigated and managed by the hospitals’ risk managers, who develop files which generally contain a large amount of legally privileged information: narratives from involved health care providers; incident reports written during the patient’s care; notes about the investigation of the event; and excerpted medical records. Historically, when a claim was received, the claims manager would contact the risk manager at the hospital involved to discuss the event with the risk manager and then receive a copy of the event file. The claims manager would also order a copy of the patient’s medical records directly from the hospital’s medical records department. It would take up to two weeks to receive a copy of the risk manager’s file, and could take up to six weeks to receive a copy of the patient’s medical records. During this time, little work could be done to evaluate the claim.

Over the past year, our office has worked with the hospitals’ risk managers and administrators to gain access to hospital databases. The hospitals’ risk managers use the same data system we use, and we have linked access to their electronic files. Now the claims manager can read the risk managers’ files online and save necessary documentation directly to our system to more efficiently manage the claim. This has eliminated the need to copy extensive documents and allows instant gathering and evaluation of information. In addition, we can access a patient’s medical records online (which is legal after a patient has filed a malpractice claim), which has eliminated the need for the hospitals to copy volumes of medical records to send to the claims managers. I estimate this year we will eliminate the copying of at least 3,000 pages of hospitals’ risk management documents and up to 20,000 pages of medical records, a definite plus for the trees involved and the personnel doing the copying. And because of this data sharing, we now are generally able to finish our evaluations and respond to claimants up to two weeks earlier than previously.

Finally, with this electronic data sharing, our time spent evaluating claims is used more efficiently, leaving more time to discuss the “lessons learned” on each case with the hospitals’ and School of Medicine’s administrators, leading we believe to improved patient care and patient safety within our system. Now if we could just find a way to eliminate the events…