Did outsourcing of cancer testing sentence a woman with cervical cancer to death?

ruman

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That’s why it has to be appealed , the consequences are that nearly all screening will have to stop if it becomes precedent .
Stop scaremongering. Mandatory disclosure is coming. You have information you provide it to patients.
 


crossman

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Stop scaremongering. Mandatory disclosure is coming. You have information you provide it to patients.
There is no scaremongering about the effect "absolute confidence" will have on screening. It will grind to a halt and that is nothing to do with mandatory reporting.
 

ruman

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There is no scaremongering about the effect "absolute confidence" will have on screening. It will grind to a halt and that is nothing to do with mandatory reporting.
If it does, responsibility for that will reside entirely with the HSE managers and medics who deliberatedly concealed information from patients.

Regretably the taxpayer will end up paying for their failings. But given the taxpayer is paying for private rooms for medical consultants there is nothing new there.
 
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crossman

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If it does, responsibility for that will reside entirely with the HSE managers and medics who deliberatedly concealed information from patients.

Regretably the taxpayer will end up paying for their failings. But given the taxpayer is paying for private rooms for medical consultants there is nothing new there.
The solicitors who pursue cases of negligence where none exists must also take some of the blame. How many times must it be said that screening is not diagnosis and there will be false negatives. The judge did not seem to understand that.
 

ruman

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The solicitors who pursue cases of negligence where none exists must also take some of the blame. How many times must it be said that screening is not diagnosis and there will be false negatives. The judge did not seem to understand that.
In the cases of medical negligence a medical expert must prepare a report stating that negligence has occurred. The HSE will also hire an expert to provide the opposite opinion. Further medical expert reports will be required to classify the extent of the damage and future care needs. Victims will be forced to return to court on a periodic basis where this process is repeated.

All in all its a very lucrative practice for medical " experts". Despite this there is zero critical commentary on the medical profession.

Any thoughts?

I know this is Ireland and one must not criticise the medical profession or allocate any " blame" to them for the costs of negligence or legal costs that are significantly increased by denying negligence ( no matter how obvious)!
 
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crossman

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In the cases of medical negligence a medical expert must prepare a report stating that negligence has occurred. The HSE will also hire an expert to provide the opposite opinion. Further medical expert reports will be required to classify the extent of the damage and future care needs. Victims will be forced to return to court on a periodic basis where this process is repeated.

All in all its a very lucrative practice for medical " experts". Despite this there is zero critical commentary on the medical profession.

Any thoughts?

I know this is Ireland and one must not criticise the medical profession or allocate any " blame" to them for the costs of negligence or legal costs that are significantly increased by denying negligence ( no matter how obvious)!
I would not quibble with any of the above in the case of medical negligence but, as far as we know, that has not been the issue with cervical screening. The only errors have been failure to communicate. This is both by those taking the smears who do not appear to have told women about the limitations and later those who did not pass on the audit results. These audit results did not of themselves suggest any negligence.
 

ruman

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I would not quibble with any of the above in the case of medical negligence but, as far as we know, that has not been the issue with cervical screening. The only errors have been failure to communicate. This is both by those taking the smears who do not appear to have told women about the limitations and later those who did not pass on the audit results. These audit results did not of themselves suggest any negligence.
Havent claimed they did, i've already stated information was deliberatedly concealed from patients. HSE management and medics should face disciplinery action as a result.

Ultimately it will be for a court of law to decide whether the deliberate failure to provide information to patients caused harm and to assess the extent of that harm. The idea that the HSE or medics involved can be trusted to rule on this is laughable.

Ideally civil proceedings would be brought against the HSE managers and medics responsible rather than them saddling the taxpayers with cost of their deliberate deceit.

Its deeply disapointing that a number of celebrity consultants rather than condemn the concealment have engaged in OTT hysteria. I have no doubt this is part or an organised campaign to take down mandatory disclosure as they did when Varadkar was health minister.
 
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Noble Guardian

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"appopriate cultural environment" ?

Not sure what you mean by that is it a culture where medics don't " deliberately remove medical records" as Justice Harding Clark put it ?

Well we best get on with reforming our culture so. This concealment of information from patients isn't acceptable in modern society. You'll always get the odd dinosaur objecting of course, they had a great run.
To remove or tamper with evidence has been an unlawful offence for quite some time. /simply introducing laws doesn't magically fix problems. Bad people will always do bad things. My worry is penalising good people for unavoidable or unpredictable bad outcomes.

As regards medical records, the issues you allude to illustrate the need for a secure and functional electronic health record. Paper is archaic.
 

Ardillaun

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To remove or tamper with evidence has been an unlawful offence for quite some time. /simply introducing laws doesn't magically fix problems. Bad people will always do bad things. My worry is penalising good people for unavoidable or unpredictable bad outcomes.

As regards medical records, the issues you allude to illustrate the need for a secure and functional electronic health record. Paper is archaic.
Where is Ireland with electronic medical records? We’ve gone that way in our hospitals and are about to convert the GP offices too. In such circumstances, altering (or even accessing) a record can be traced to a particular person on a particular date. A physician who stupidly tried to do that here was promptly reported to our licensing authority. There are some concerns that US and other companies might be forced to put backdoors into their systems but the benefits greatly outweigh the risks.
 
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ruman

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To remove or tamper with evidence has been an unlawful offence for quite some time. /simply introducing laws doesn't magically fix problems. Bad people will always do bad things. My worry is penalising good people for unavoidable or unpredictable bad outcomes.

As regards medical records, the issues you allude to illustrate the need for a secure and functional electronic health record. Paper is archaic.
Well we are agreed on that. Records should be electronic and available immediately to patients to access and use as they please.

Any alteration after the fact should set off an immediate red flag.
 

ruman

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Where is Ireland with electronic medical records? We’ve gone that way in our hospitals and are about to convert the GP offices too. In such circumstances, altering (or even accessing) a record can be traced to a particular person on a particular date. A physician who stupidly tried to do that here was promptly reported to our licensing authority. There are some concerns that US and other companies might be forced to put backdoors into their systems but the benefits greatly outweigh the risks.
Whats worrying is the number of incidences where some of the most senior consultants in the state have reviewed records and failed to highlight alterations.

Even more worrying is when it is brought to their attention they attempt to excuse it.

Alterations are endemic here and given senior medics are unwilling to point out this behaviour is unacceptable its hard to see that changing.
 

Ardillaun

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Whats worrying is the number of incidences where some of the most senior consultants in the state have reviewed records and failed to highlight alterations.

Even more worrying is when it is brought to their attention they attempt to excuse it.

Alterations are endemic here and given senior medics are unwilling to point out this behaviour is unacceptable its hard to see that changing.
With an EMR system, suspicious activity can be detected by Health Information personnel and reported directly to senior admin staff who are obliged to take action and refer the matter to the appropriate authorities. Altering a health record is a serious matter. Here’s an example. One could argue that the punishment was too light but at least the offence was documented and made public:

Cheshenchuk later admitted guilt to professional misconduct with the College of Physicians and Surgeons of Saskatchewan for the alterations. The doctor was given a month-long suspension and fined more than $7,000.

Specifically, she admitted guilt to failing to maintain Hendricks’ record, making several alterations to the record, not completing the record in a timely manner, and failing to exercise due diligence to ensure that the information in the record accurately reflected the care provided to Hendricks.

Cheshenchuk is now the subject of a lawsuit filed by Hendricks’ daughter, alleging the doctor was negligent in her treatment of Hendricks and that she failed to send her to the hospital.
 
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Noble Guardian

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Radiology are the most advanced when it comes to electronic records. Its been long in the making, based in part on an EU mandated common technical langue for imaging. That then led to compatible systems, unlike many standalone software platforms in other departments.
S radiologist in Dublin can look at images taken in Kerry, in the public system at least.
 

Noble Guardian

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With an EMR system, suspicious activity can be detected by Health Information personnel and reported directly to senior admin staff who are obliged to take action and refer the matter to the appropriate authorities. Altering a health record is a serious matter.
All medical records are retrospective to sone degree, with the possible exception of resuscitation where a scribe is appointed.
There's nothing inherently devious about retrospective notes or corrections, so long as they're clearly marked. Subtle findings may only be recollected when thinking back over the day's work.
While contemporaneous notes are best, complete and accurate is what actually matters.
 

ruman

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All medical records are retrospective to sone degree, with the possible exception of resuscitation where a scribe is appointed.
There's nothing inherently devious about retrospective notes or corrections, so long as they're clearly marked. Subtle findings may only be recollected when thinking back over the day's work.
While contemporaneous notes are best, complete and accurate is what actually matters.
Whats your view on alterations a couple of weeks or longer after?

Should it merit a comment from a senior consultant in the event of them reviewing said records?
 

Ardillaun

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Radiology are the most advanced when it comes to electronic records. Its been long in the making, based in part on an EU mandated common technical langue for imaging. That then led to compatible systems, unlike many standalone software platforms in other departments.
S radiologist in Dublin can look at images taken in Kerry, in the public system at least.
We’ve had a province-wide PACS system like that for all radiology imaging for many years. Once a patient’s image is taken, it’s assigned to a radiologist and it’s their responsibility to get the report signed. If our dept. is short-staffed, the excess is simply referred out. Thus a scenario of thousands of unsigned radiology cases is highly unlikely.
 

ruman

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With an EMR system, suspicious activity can be detected by Health Information personnel and reported directly to senior admin staff who are obliged to take action and refer the matter to the appropriate authorities. Altering a health record is a serious matter. Here’s an example. One could argue that the punishment was too light but at least the offence was documented and made public:
I'm interested in your comment stating admin staff are obliged to refer the matter to the authorities. Is this in Ireland and what literature or policies are there backing this up?

Were it brought to the attention of admin staff and zero action taken what action is possible against admin?

It seems you are referring to Canada. Complaints against medical staff in Ireland from the HSE are non existent.
 

Ardillaun

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I'm interested in your comment stating admin staff are obliged to refer the matter to the authorities. Is this in Ireland and what literature or policies are there backing this up?

Were it brought to the attention of admin staff and zero action taken what action is possible against admin?

It seems you are referring to Canada. Complaints against medical staff in Ireland from the HSE are non existent.
I am referring to Canada.
 

Ardillaun

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All medical records are retrospective to sone degree, with the possible exception of resuscitation where a scribe is appointed.
There's nothing inherently devious about retrospective notes or corrections, so long as they're clearly marked. Subtle findings may only be recollected when thinking back over the day's work.
While contemporaneous notes are best, complete and accurate is what actually matters.
In Canada, corrections are acceptable under certain circumstances.


Problems arise when they are made after, say, the unexpected death of a patient or, of course, when they seek to give an erroneous impression of the original interaction. The original record must always be available.

Many records should be completed the same day or shortly thereafter. Occasionally, a physician may take so long to complete a report that that the chart has to be declared permanently incomplete.
 
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ruman

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I am referring to Canada.
Fair enough, sadly doesnt apply over here. I am aware of a few medics who left Ireland under how can i put it " a cloud" to go to Canada. Sordid business.

* Sorry that wasnt directed at you. I'm sure most leave for valid reasons and i wouldnt blame them
 
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