A new report has claimed that a growth in the use of electronic patient records (EPRs) may encourage a culture pf “electronic ambulance chasing.”
Tom Marshall, author of the article and professor of public health and primary care at the University, claims that the adoption of new technologies can have unexpected consequences.
Marshall notes that in order to demonstrate medical negligence, a claimant must demonstrate that the doctor failed to meet the required standard of care and because EPRs must be disclosed to patients on request, it is likely they will be used to affect the conduct of litigation.
Although claimants using electronic medical records to support their claims is not a new practice, he believes that rather than initiating legal action first and then requesting the records, the patients will now instead request their records first and then decide whether any negligence occurred.
“Because it is much easier to search electronic than paper records, a patient who has experienced an adverse event could first request their medical records and then initiate legal action,” claims Marshall.
“Or, more accurately, lawyers could actively seek permission from everyone who experienced an adverse event to search their records in the hope of identifying an opportunity for medicolegal action,” he adds.
To support its argument, the paper uses a number of examples where requesting one’s medical record may lead to the decision to pursue legal action.
In the UK guidelines recommend urgent investigation of iron-deficiency anaemia for suspected bowel cancer.
However, this only happens for fewer than half of patients with the condition, and only one third are referred to the right speciality.
Lab tests and reported symptoms are all recorded in EPRs and so evidence of eligibility for referral is easily identified in those patients who get diagnosed with bowel cancer.
This makes a negligence claim possible and a doctor who fails to document reasons for not investigating previous iron-deficiency anaemia or other symptoms in a patient with cancer may find it hard to offer a defence.
“The archive of data in electronic medical records is an uncompromising documentation of events. It is easy for a lawyer to request a patient’s EPR,” claims Marshall.
“If the GP has offered treatment or investigation but it is documented that the offer was declined, this is a robust defence. If there is documented a rationale for not offering treatment or investigation then there is no problem.
“A negligence claim is possible if the GP is unaware of guidelines or simply did not consider the appropriate treatment or investigation.
“There is an old adage that if it is not in the records then it did not happen. If there is an absence of justification for inaction in the records then this absence itself is sufficient evidence,” he adds.