Patient Safety

10 Years of Improving Patient Safety and Care

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

It is with great pride and joy that I announce that this month – July 2021 – the Physician-Patient Alliance for Health & Safety (PPAHS) is turning 10!

Ten years ago today, when I pressed the publish button on the very first article to be hosted on a free WordPress blogging site, I frankly thought that the site would be up for about 6-months. At that time, I did not think that PPAHS would be celebrating 10 years of improving patient safety and care.

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Patient Safety

Physician-Patient Alliance for Health & Safety Position Paper calls for improved lung testing technologies and clinical procedures

An insightful Position Paper published by the Physician-Patient Alliance for Health & Safety (PPAHS) coinciding with the American Thoracic Society’s annual conference [ATS 2021] recognizes the need for improved technologies and procedures to measure lung dynamics and function that can be safely sustained during pandemics. 

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Patient Safety, Practices & Tips

How Patients Can Stay Safe During Telehealth Visits

By Brad Smith (technology expert, TurnOnVPN, a non-profit organization focusing on a free and unimpeded internet for all)

Introduction

During the COVID pandemic, many patients were stuck at home, left with no way to make their regular medical appointments. For this very reason, many doctors, therapists, and psychiatrists began emphasizing the importance of telehealth. 

Image from Unsplash.com

According to JAMA Network Open, telehealth services saw a greater than 1000% increase last March—around the time the pandemic started.

With telehealth, patients could continue their regular appointments with little hindrance, medical resources on-site wouldn’t be so strained, and it would be easier than ever for doctors and patients to communicate with each other.

Dangers Facing Telehealth Patients

All that said, telehealth patients need to be careful when using telehealth services. Why? Cybercriminals have begun focusing on telehealth services in a couple of ways.

Note that these risks affect patients more so than medical practices. The reason being that, while medical practices are required to pay attention to cybersecurity and follow HIPAA Compliance, patients are often caught lacking in the cybersecurity department.

Data Breaches

Let’s start by talking about data breaches. If neither the patient nor the medical staff neglect proper cybersecurity, it becomes easy for a cybercriminal to breach both parties’ data. 

For example, an unsecured call opens both the patient and staff up to a man-in-the-middle attack, a practice where a cybercriminal listens in on a call and intercepts the data transfer between both parties. Patients are especially vulnerable to this if they are not on a secure network. 

Phishing Scams

If cybercriminals have learned one thing, it’s that phishing scams, unfortunately, work. The reason for this is that when it comes to serious topics like anything regarding a patient’s health, they will respond before they verify the source of the email.

Typically, phishing scams will ask for personal information or take the patient to an online form where they will fill out a form with tons of their personal information (their social security number, for example).  

How Patients Can Secure Their Devices

Fortunately, there are plenty of ways that patients can secure their data while using telehealth services. Today, let’s go over three of the best ways to do so.

1. Encrypt Their Connection

To avoid data breaches (on the patient’s end) and man-in-the-middle attacks, it is recommended that all telehealth patients encrypt their connections. This means strengthening the security of their network and encrypting the data their device sends out during a telehealth visit.

Modern home networks often come with good encryption, so patients should mainly focus on encrypting their device’s data with a VPN, a Virtual Private Network. What a VPN does is actively encrypt the data your device sends out and anonymizes your presence on a network, making it a perfect solution for active data encryption.

2. Use Strong Passwords for Telehealth-Related Accounts

Many doctors use services like MyChart to make patient communication easier. Messages, test results, and notes: telehealth services like MyChart are useful for both patients and medical staff. And since private patient information is shared on these services, patients often need to create accounts and secure their accounts with a password.

That said, some patients probably don’t use as strong of a password as they should. If you use an online telehealth service, make sure that your password is strong enough that a cybercriminal can’t guess it.

3. Scan Their Device(s) for Malware 

Patients need to routinely check their devices for malware. Since certain types of malware—spyware and keyloggers being major culprits—can often go undetected for extended periods of time, performing routine scans will help patients stay secure, especially during telehealth visits.

Conclusion

With a rise in telehealth comes a rise in cybercriminals targeting patients with scams and cyber-attacks. To stay safe, patients need to do the best they can to secure their devices, which means using strong passwords, scanning their devices for threats, and encrypting their data.


Brad Smith is a technology expert at TurnOnVPN, a non-profit promoting a safe and free internet for all. He writes about his dream for free internet and unravels the horror behind big techs

 

Patient Safety, Position Statement

Race is a Patient Safety Issue

On May 25, 2020, George Floyd was killed during an arrest by the Minneapolis police. Since that time, Derek Chauvin (one of the police involved in that incident) has been found guilty of second-degree murder, third-degree murder, and manslaughter, and the other three former Minneapolis police officers involved in his death have been indicted on federal civil rights charges.

There have been calls for policing to be reformed. However, we must acknowledge that Black Lives Matter goes beyond policing. 

Race is a patient safety issue. As the Association of Black Cardiologists stated with the American Heart Association and the American College of Cardiology on May 31, 2020:

“Like cardiovascular disease, acts of violence and racism are core causes of psychosocial stress that promote poor well-being and cardiovascular health, especially for communities of color. Given that heart disease and stroke are the leading causes of death for communities of color, particularly African-Americans who have the lowest life-expectancy of all racial/ethnic groups living in the United States, we are extremely disturbed by violent acts that cut to the core of the lives of our community. Therefore, along with other leading health organizations, we DENOUNCE incidents of racism and violence that continue to ravage our communities … The profound grief and stress triggered by these events, as well as the consequences for black lives, contribute significantly to cardiovascular risk. Each episode has emotional and physiological effects on individuals and all communities.”

Disparities, inequities, violence, and racism are completely unacceptable. 

We must act NOW to address any and all inequities in the delivery of care. We must recognize that Black Lives Matter is not just a call for justice and about the murder of George Floyd, but also a time to fix healthcare inequalities wherever they exist. 

We must act NOW to:

  • Actively be anti-racist.
  • Recognize that racism is not just a health disparity issue, but a societal issue that has a profound impact on ALL communities.
  • Identify and call out racism, whether that it exists in ourselves, our neighbors, or in our leaders.
  • Listen and follow black voices, like the Association of Black Cardiologists and the National Black Nurses Association.

To read the Physician-Patient Alliance for Health & Safety position statement, “Black Lives Matter, Healthcare Inequalities, and the Need for Systemic Change, please click here.

Malpractice, Patient Safety, Respiratory Compromise

Malpractice Cases Likely to Rise Post-COVID Due to Delayed Diagnosis

At the recent Crittenden Medical Insurance Conference held virtually from April 13-14, 2021, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety (PPAHS)) predicted that malpractice cases will likely rise post-COVID due to delayed diagnosis.

Presenting with Mr. Wong were:

  • Naresh M. Punjabi, MD, PhD (Mary Jane and Lino Sertel Professor of Pulmonary Diseases, Department of Medicine, University of Miami, Miller School of Medicine) 
  • Jason P. Kirkness, Ph.D. (Medicine), ATSF (Drug/Device Discovery and Development Committee, American Thoracic Society; VP Medical and Clinical Affairs, 4DMedical)

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Patient Safety

Top 5 Concerns Adult Parents Have About Caring for Their Aging Parents

Editor’s note: Millions of US adults who care for aging parents worry whether they can cope, how their family will react, and their relationship with their mom or dad.  

By Aaron Goldsmith (owner, Transfer Master)

Caring for an elderly parent can be one of the most rewarding things you will ever do. But it can also be a source of stress, resentment, and burnout. Becoming your elderly parent’s caregiver is a huge responsibility, and it often entails a significant change to your lifestyle. You might be worried about how your family will react or whether you can cope with your parent’s care needs, especially as they get older. 

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Malpractice, Patient Safety

Risks and Liabilities of Delayed Diagnosis During COVID-19

The Physician-Patient Alliance for Health & Safety (PPAHS) is pleased to announce that it will be moderating a panel discussion on the risks and liabilities of delayed diagnosis during COVID-19 at the upcoming Crittenden Medical Insurance Conference to be held virtually from April 13-14, 2021. If you would like to attend the Conference, please register here.

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Patient Safety

Patient Safety in Other Languages

[Editor’s note: PPAHS believes in removing as many barriers to communication between clinicians and their patients. With that goal in mind, Louise Taylor discusses how medical interpretation services can be an effective tool to facilitate clinician-patient discussions.]

By Louise Taylor

Patient safety goals should be a primary concern no matter which language you are speaking. As such, you may need the medical interpreting services to make sure important patient instructions are not lost in translation. Below, we’ll cover some of the top ways to make sure you are working with medical interpreting in a way that keeps your patients safe, no matter which languages they may speak. Interpreters in this medical field speak the language of medicine—they are there at points in the patient’s journey from making a medical appointment to outpatient doctor’s visits to clinical consultation to drug diagnoses. They help remove the language barriers between the doctor and the patient.

Map Your Medical Interpreting Needs

The first thing to be clear is which languages you are likely to need. Understanding the demographics of your local area will help with this, as will analyzing your current patient list and your previous experiences where language barriers have been a concern. Knowing in advance which languages you are likely to need can ensure that you use the best service for your needs. 

You’ll also need to understand just what that service entails. What is medical interpretation? Medical interpreting is a specialized interpretation for the medical field. Interpreting often happens in real-time, such as having an interpreter present during a consultation with a patient. The interpreter’s role is a pressurized one, as they have only a split second to find the right phrase and deliver it in the target language. They also have to deal with the emotional side of the work, such as when a doctor delivers bad news to a patient. 

Plan Ahead

Plan ahead regarding when you will need to access the service. While it is much easier to find medical interpretation services than it used to be, since many services are online, planning ahead can avoid last-minute scrambling. Using any old service could put your patient safety at risk.  

One way to have an organized medical interpreting process is to keep track of when appointments are scheduled with patients who don’t speak English. You can plan ahead to have the service ready when they arrive.  

Use a Professional Service 

Your medical interpreter’s level of skills and experience is of the utmost importance. They should be knowledgeable about interpreting best practices and experienced in the role. They should also have patient safety concerns at the forefront of their professional goals and know medical terminology in both languages.  

You can assess a professional service in a number of ways:

  • Look at independent consumer reviews of the service before contacting them.
  • Check the background of the interpreters the agency employs or the individual interpreter that you are thinking of using. How long does it take to become a medical interpreter? Often years. A medical interpreter should have a background that shows they are fluent in the language, such as higher education qualifications, extensive work experience and belonging to a professional organization.
  • Medical interpreting also has industry certifications, where interpreters sit a rigorous test to prove that they are at the top of their field.  

By properly vetting the medical interpreting service you plan to use, you can make sure you’re working with a professional company that values patient safety.

Make Accuracy Your Priority 

It’s important to look into how the service assures and values medical interpreting accuracy. For instance, it’s common for services to have some kind of rotation and break schedule in place for their interpreters, given the mentally demanding nature of the work. If the service has people doing medical interpreting jobs for hours on end without a break, they don’t value either their interpreters’ or patient safety as much as they should.  

Because medical interpreting often happens in real time, where an interpreter must convert spoken language on the fly, it can be very draining; a good service will mandate some kind of brake system or even swap out interpreters to keep them alert.    

Interpreters in this field cover everything from patient diagnoses to doctor-to-patient clinical interactions to setting up medical appointments to specifying instructions and drug interactions. They are the language experts of the medical field. 

Consider Remote Services  

Video and remote working has become the norm since the pandemic. 81% of people want to continue working remotely at least some of the time, while 61% want remote work to become their primary way of working. 

Zoom’s expansion reflects this. The service grew to 300 million users in April 2020. Many of those providing medical interpreting services have been using it. This kind of video remote interpreting is where an interpreter is present in the conversation through video chat. It’s cheaper than having interpreters attend in person. It can be a great solution for getting the best services for your needs, no matter where they are located. 

Understandably, the use of remote interpreters has expanded greatly during the pandemic, making it possible for you to have interpreters present while keeping everyone safe.  

However, to meet your patient safety goals, make sure your technology is up-to-date and you have a fast internet connection. Well-connected video is the key to making sure conversations are well-interpreted and understood with video remote interpreting.  


Louise Taylor is a copywriter with a particular interest in languages, including how they are used across a range of industries.

 

Patient Safety

I got the COVID Vaccine, have you?

By Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)

Here is my story of efforts to get the COVID vaccine, waiting, waiting, and more waiting … and then finally receiving the first dose of Pfizer COVID vaccine.

Like many people around the country – and indeed the world – I met the news of approval of vaccines against COVID-19 with joy and some trepidation. Joy because a COVID vaccine could mean an end to physical distancing and mask wearing, and a return to some normalcy. 

There is No Cure for COVID-19

The anti-COVID vaxxers will tell you that there is a cure for COVID-19 – this is FALSE! Don’t let this misinformation prevent you from protecting yourself and your loved ones.

There are treatments that are being used to try to stop the progression of COVID-19, but there is NOT a cure for COVID-19. 

Getting the COVID Vaccine is Not Worse Than Getting COVID

The anti-COVID vaxxers will also tell you that getting the vaccine is worse than getting COVID – this is FALSE! Don’t let this misinformation prevent you from protecting yourself and your loved ones.

Researchers have found that there are long-term effects of getting COVID-19. Anthony L. Komaroff, MD (Editor in Chief, Harvard Health Letter) writes 

“When people first started getting sick with COVID, doctors thought that it affected primarily the lungs. Unfortunately, we quickly learned that it also could affect the heart, kidneys, brain, and other organs.

“There also are people who survived COVID and have no evidence of injury to the heart, kidneys, or brain — but who nevertheless have not returned to full health. They still have fatigue, body aches, shortness of breath, difficulty concentrating, inability to exercise, headache, and trouble sleeping. Some studies find that more than 50% of people who “recovered” from COVID remain hobbled by these symptoms three months later. They can’t return to work. They can’t fulfill their responsibilities at home. They are being called “long haulers.”

The Mayo Clinic, in looking at those who get mildly sick from COVID, concluded:

“some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery.

“These people sometimes describe themselves as ‘long haulers’ and the condition has been called post-COVID-19 syndrome or ‘long COVID-19.’

“Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection.

I also met the news of COVID vaccine approval with some trepidation. I like many people who had questions about how the vaccine works, been tested, and approved:

  • Is the vaccine safe?
  • What are the side effects of taking the vaccine?
  • Was the approval of the vaccine politically motivated?

My Experience Getting the COVID Vaccine

However, what I probably should have feared most was the uncertainty and the efforts I would need to exert to get an appointment to receive the vaccine. I signed up on my state’s site to get the vaccine when it was approved and dutifully filled out the state requirements – giving my age, address, whether I was a frontline worker, whether I had an existing condition … and waited, and waited, and waited …

After some time and not getting an appointment for a vaccine shot, despite being in a priority group, my local news told me that individual clinics and hospitals were providing the vaccine outside of the state registration site. In short, a double vaccine system had been created – one run by the state in which I resided and one run by healthcare facilities that were able to get supplies of the COVID vaccine – in short, chaos!

When there was news that pharmacies were getting the COVID vaccine, I searched those sites online – no result.

I even entered into daily “lotteries” to get the vaccine – no result.

Then, out of the blue, I won the vaccine lottery – I got an email from a local hospital asking me to schedule a time to take the vaccine. I didn’t hesitate and scheduled the first available appointment for a few days later – and received back a confirmation of the time, as well as instructions to bring the email, ID, and proof of insurance. The email also said to “Please wear a mask when you arrive and ensure you wear clothing that allows access to your upper arm” and warned “If you have a fever or cold/respiratory symptoms on the date of your vaccine appointment, you will not be able to proceed with your vaccination.”

At the appointed time, I went to the vaccine site, a Federal Emergency Management Agency (FEMA) “mega” site at a nearby convention center. Even though it was still quite early in the morning, the parking lot at the convention center was full and a small queue of people had already formed at the entrance.

At the entrance, I showed the greeter my cell phone confirming my appointment, and then I found the end of the line. Looking at the long line, I thought that this is just like standing in line at Disneyland – only a fun ride was not at the end, only a much needed vaccine. Thankfully the line moved very quickly and I soon came to the first of four stations – at this first station, I showed my driver’s license and received back a numbered card, with the instructions that the card would be collected at the end.

I then joined another fast-moving line that brought me to the second station – the registration desk. Here I was greeted by a very pleasant young man from FEMA. As he entered the required information on a laptop, we chatted. I found that he was with the local national guard, that he is going to get married soon, and that he hopes to travel the world with his new wife.

He then sent me on my way to the third station filled with many partitions behind which clinicians were providing the vaccine shots to individuals. The nurse asked me whether this was my first dose of the vaccine, whether I had had COVID-19, and whether I had any of the medical conditions listed in large type on the 8.5” by 11” sheet. She told me that about 4,000 shots would be administered that day at the site (I don’t think she told everyone this – we were just chatting, I was curious and she was happy to engage in friendly discussion). She then proceeded to very efficiently put one end of a band aid on my left arm, swab the area to be injected, give the injection, and put the other end of the band-aid on my arm. 

Getting the COVID vaccine shot was no different than getting any other vaccine.

The nurse then told me to go to the fourth and final station where I was to wait for 15 minutes before departing (negative reactions like anaphylaxis appear within the first few minutes of vaccination). She explained that I was also going to get a text scheduling my second vaccine dose, and that if I had any questions that there were people at the fourth station to answer my questions.

I did indeed get a text to schedule my next dose – which I scheduled for three weeks hence. As I waited for 15 minutes, I also signed up at the CDC site vsafe.cdc.gov, where in exchange for some basic contact information, I was told that vsafe would periodically check-in to see that I was ok. vsafe.cdc.gov has indeed checked in with me as promised. At this fourth station, there was also staff roaming around to ensure that all vaccine recipients were ok. 

When my allotted 15 minutes were up, I exited the mega-site, where I turned in the numbered card I received at the first station and received a small bottle of hand sanitizer – good for use in the car, I thought.

The whole process from start to finish – about an hour.

Side effects – none. I have had NO side effects from getting the COVID vaccine. I have not had an anaphylactic event or Bill Gates’ microbes inserted into my bloodstream.

My advice – get the COVID vaccine when you can! 

 

Patient Safety

Physician-Patient Alliance for Health & Safety is now an accredited provider of continuing professional development

The Physician-Patient Alliance for Health & Safety is pleased to announce that PPAHS is now an accredited provider of continuing professional development (CPD). 

PPAHS will be providing CPD courses accredited through the CPD Standards Office, a world-leading accreditor. 

CPD/CME credits are required annually to maintain medical licenses for doctors, nurses, and other clinicians. In addition, most hospitals require a specified number of credits for their physicians to remain credentialed to see patients. CPD and CME “help medical professionals maintain and upgrade their knowledge in the chosen medical field and broaden their personal and professional experience after obtaining the postgraduate degree and becoming specialists. Above all, CPD-CME enhances the quality of patient’s care by constantly improving the physician’s skills, broadening the physician’s professional outlook and helping him/her to keep up with the vast amount of scientific information constantly being generated.”

CPD is a broader term than CME covering different educational programs. Internationally there is a move from CME to CPD, and PPAHS’s accreditation as a CPD provider reflects PPAHS’s national and international following.

“The Physician-Patient Alliance for Health & Safety has since its establishment in 2011 been a medical educator through our podcasts, webinars, and conference presentations,” explained Michael Wong, JD (Executive Director, PPAHS). “Being able to provide CPD credits for our activities now means that doctors, nurses, and other clinicians can receive recognition for participating in our educational initiatives.”

PPAHS’s first course offering CPD credits will be “Respiratory Compromise Prevention, Recognition, and Intervention.” Other courses are planned in critical issues to help improve patient safety and care, said Mr. Wong.