Health Law III Flashcards
What does EMTALA stand for?
Emergency medical treatment and labor act
What is the gist of EMTALA?
EDs must do a minimum screen for stabilizing patient before they can transfer
Does EMTALA apply to every patient and every hospital?
Every patient, but only hospitals that take medicare or medicaid
What are the criteria for EMTALA?
- pt comes to the ED
- Requests an exam
- must be provided with an appropriate MSE to determine if it is an emergency condition
Can you discriminate how the screening exam is performed based on the patient?
No
Under EMTALA, what is an “emergency medical condition”? (5)
A medical condition manifesting itself by acute symptoms of sufficient severity including severe pain, such that absence of care could result in:
- Health is in jeopardy
- Impairment of bodily functions
- Prego an in contractions
- Inadequate time to transfer
- Transfer may pose a threat
Who can the pt sue under EMTALA?
The hospital, not the doctor.
Who can get fined under EMTALA- the hospital or the dr?
Either or both
True or false: a patient must prove that a violation of care was done under EMTALA
False–just need to prove that treatment was different from others in similar conditions
Are there caps to an emtala violation in iowa?
No
Can insurance cover EMTALA violations?
No
What are the sanctions for the hospital or physicians for violating EMTALA?
No more medicare
True or false: EMTALA covers all pts, regardless of where they present to the hospital
True–anywhere on the premises
Is divergence an EMTALA issue?
No
What is meant by “provide stabilizing care” under EMTALA?
- If pregnant, then must deliver (including placenta)
- Cannot result in material deterioration of the condition is likely to result from transfer or d/c
Is transferring patients for medical necessity a violation of EMTALA?
No
Can a patient request to be transferred and not violate EMTALA?
Yes, but need to inform them
What does transfer mean in the context of EMTALA?
-Anytime patient leaves the campus of the hospital including d/c
Can you ask the patient about the ability to pay prior to examining them?
No
What are the requirements for on-call physicians under EMTALA? (3)
Must maintain an on-call system to provide coverage, and it must include:
- every specialty
- name of drs
- must be posted in the ED
What must be done, prior to transferring a patient under EMTALA? (2)
- Must certify benefits outweigh risks
- Document specific risks/benefits
Can you transfer a patient via their car under EMTALA?
No
In what timeframe must EMTALA violations be reported?
72 hours
What is the difference between a claim and a malpractice suit?
Claim is just informing of intent against filing a malpractice suit
True or false: you will probably face a claim in your career
True
What are the top two specialties that have the highest average indemnity payments?
- Peds highest
- Family practice
What is the top claim?
Failure to diagnose
What are the top 4 causes of malpractice claims?
- lack of communication with pt
- lack of coordination with providers
- system failures
- documentation
True or false: if you didn’t document it, it wasn’t done
False
What is the metadata associated with the EMR?
Data about data:
-who did what and when
When is metadata not helpful for defense?
If entered in at a much later time
Does the amount of time a physician spends with a patient saved in the metadata?
Yes
What are the two criteria that must be met when requesting metadata?
- Relevant to claim or defense
- Not privileged information
What is the problem with alerts on EMR, besides that they’re annoying?
-Does not communicate standard of care
What is the difference between omission vs commission in terms of alerts?
Omission = ignore Commission = turn off
Should you ever go back into the medical record of pts that you ended care with?
No
What does jousting mean in the EHR?
Pass blame on someone else in the medical record.
Does pain qualify as an emergency medical condition under EMTALA?
Yes
Does triage count as a MSE?
No
True or false: if you receive a patient where EMTALA was violated, you are required to report them
True
