The Problem - Part the First
Before we launch into this a quick review is in order; most items that appear on your hospital bill first originate as a physician’s order. The computer stores the order and a bill is generated. For supplies, the patient is charged for it item used by various methods including transferring stickers from the item to the charge card.
It doesn’t take much research online to find stories of millions of dollars in medical bill overcharges. And that is what we will investigate in the first part of the Problem, or human error.
Everyone makes mistakes and that happens when entering orders as well. Perhaps the date is wrong or the test is not exactly what the physician ordered, also medical terminology, abbreviations and poor hand writing all contribute. In short, any thing could and probably does happen.
I know I have been called by lab and radiology and even dietary asking about an order in the computer. Just the other day I was called by lab and asked if I wanted the magnesium level drawn now even though one was done earlier in the morning. Since there was no order I said no.
Literally, sometimes getting a lab value or an x-ray is a matter of life or death and in those cases a phone call, an urgent tone of voice plus a promise of an order in the near future will get the lab or x-ray done immediately.
Once the situation has passed is an order placed? That is the goal yes, but like other things sometimes it is missed.
Other save guards are in place also, for instance hospitals may require doctors to enter there own orders into the computer. This eliminates several steps and presumably would cut down errors but not always. Nurses routinely do chart checks to make sure the orders are noted and correct.
As for the supplies, I can give you an example. One night I was particulary busy tending to two ill patients. Running from task to task to make sure each had proper care. When I finally sat down I had stickers from supplies all over my top.
Of course I tried to put the appropriate sticker with the proper patient. And I think I did just that, but with a hectic work load there stickers sometimes are misplaced.
And finally I would like to relate to you a case of human error that was very well intentioned and not discovered immediately. As I have said I have worked in a variety of care settings. And this example took place in the NICU. We had the habit of placing small squares of fleece beneath the babes. This was to prevent skin breakdown and make the issolette more comfortable.
Little did we know that these fleece squares also made the x-rays appear pathcy, with more white than there otherwise would have been. So what started as a well meaning comfort measure actually was counter productive.
Billing errors are common on medical bills. And as I have described above some of these overcharges are the result human error inputing the charges. Part II however deals with a different sort of problem.
Tuesday, November 6th, 2007