Obviously this is a colossal mistake, and a violation of privacy, decency and common sense.

These types of HIPAA transgressions could lead to the following consequences for the patient and the violator:

• People can lose their health insurance
• People can have their identity stolen and experience financial fraud
• It can cause personal embarrassment
• It can cost people their job
• Employees can lose their license and/or acquire a criminal record

The implications can be life changing for all parties involved.

People make mistakes. However, our culture of “instant communications” and social media make people more prone to these types of errors than ever. One quick text or tweet without thinking it through, and a patient and employee’s life can change dramatically for the worse. This is a good reminder. We in the medical management and insurance industries must be vigilant with our employee training, policies, and procedures.

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The tragedy at Orlando’s Pulse nightclub was horrific, with 50 total deaths.  Everyone can understand and see the sheer scale of the largest shooting in US history.

Our nation has 8,000 times that many people die each year from medical mistakes – or 400,000 deaths annually. That’s equivalent to 22 of these shootings…every single day of the year. These deaths may not be making daily headlines, but they are happening – one person at a time, one treatment at a time, all across the United States.

A recent news story on the subject shows how easily it can happen. If you , the story of how this child died is at the end of the clip. She was given the wrong medicine, a compound medication, 20+ times stronger than what she needed. The pharmacist signed off, without making it or reviewing it. Her father found the IV bag in the trash, so it’s likely nobody would have told him had he not caught it. It’s also very telling that his settlement would have been significantly higher had he agreed to a confidentiality clause, but he thought it was important for the memory of his daughter to speak out. These cases are usually not spoken about publicly.

I am a big proponent that less is usually more in healthcare. I am very proud of what we do at 911�Թ�. For patients involved in 911�Թ�’s medical care management, utilization review and surgical care programs, every unnecessary medical service we prevent could be the one that saves a life. Every surgery we keep out of a hospital can reduce the risk of error or infection and increase the odds of a successful recovery. There is no doubt that these precautions help reduce devastating health issues for our patients every day.

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We’ve heard that:

• Shark attacks are up in the US (53 in 2013, vs. 42 in 2012).
• Terrorism and mass shootings (or “multi-party shooting incidents”) are responsible for in the US in 2015.

These are, of course, terrible.

Yet, I recently wrote about how the US has over 440,000 deaths per year from hospital errors. These fatalities are 1,000 times worse than those from the mass shooting crisis our nation is facing, and yet I’ve not heard one mention about this in any presidential debate thus far.

Now, we have 47,000 people in a single year according to the CDC’s latest 2014 figures. This problem has an impact 100 times greater than the mass shootings. When you consider that the majority of mass shootings are drug-related (dealer infighting), the issue of drug usage becomes glaringly apparent. When you also consider that these shooting figures do not account for single-incident and police shootings – including the civil unrest caused by the “war on drugs” that is tearing apart the social fabric of areas of our nation – drugs become an even more critical issue.

The comparison to the gangsters and rampant violence in the US during Prohibition (a.k.a, “the war on alcohol”) is an obvious one to me.

If you think that regulations and stricter controls are the answer, consider this: over 50% of all drug overdose deaths result from highly regulated prescription drugs (16,235). That is nearly double those from street heroin (8,257). When you realize that most new heroin users began as prescription opioid abusers, the idea that regulations will assist in solving this problem seems a bit absurd.

I have thought long and hard on this issue.

I hate what addiction does to families and individuals. Just like alcohol, some people can take medications with no adverse impact on their lives, while others have a propensity to addiction. I have experienced addiction problems in my own family, and I would not wish them on anyone.

Still, I am a data guy. If something is not working, and something else would work better, the correct answer seems obvious. I believe our country’s drug problem is a health issue — not a criminal issue. Countries such as Belgium that have shifted focus from prosecution to treatment have seen a significant reduction in both crime and addiction. Likewise, when addressed their drug crisis by shifting their strategy from punishment to treatment, the country saw drug usage, addiction, health issues, and incarceration rates all decline.

Alex Stevens, a professor of criminal justice at the University of Kent states: “The main lesson to learn – decriminalizing drugs doesn’t necessarily lead to disaster, and it does free up resources for more effective responses to drug-related problems.”

We have seen positive results from the legalization of marijuana in some states in the US, similar to those in the countries mentioned above. This change has certainly not led to any “crisis.”

My conclusion? The best approaches to address and reduce these issues are exactly what 911�Թ� is doing today. For example, patients in 911�Թ�’s Ultimate early intervention program, whose treatment is overseen by nurse case managers, have experienced very significant decreases in drug and opioid usage.

Our pharmacy review program focuses on long-term usage/addiction and does not cut patients off. Instead, patients are guided through a weaning program to prevent them from moving to harder and even more dangerous drugs.

Our Pharmacy Benefit Manager (PBM) partners also have formularies to prevent unnecessary prescriptions and addiction. Such programs positively impact people’s lives without the need to criminalize behaviors that might lead to jail or violence.

We are having a substantial and lasting impact on society, and these are treatment efforts that we can – and should – be proud of.

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This is about a study done to compare the skill of doctors performing surgeries. In the study, a group of surgeons watched videos of other surgeons performing gastric bypass surgery, they then rated them on their skill level.

The differences between the most skilled and least skilled surgeons were remarkable. Comparing the top 25% to the bottom 25%, the study found:

• The least-skilled surgeons had nearly triple the rate of complications, 14.5% versus 5.2%.
• The least-skilled surgeons required longer operations, 137 minutes versus 98 minutes.
• Although death is a very rare outcome for gastric bypass surgery, patients had a higher risk of dying if their operation was done by the least-skilled doctors, 0.26% versus 0.05%.

The fact that peers could tell the most skilled providers vs. the least skilled was no surprise. What jumped out to me was the vast difference in speed. The best outcomes came from the people that did the surgery the fastest. They were the most skilled, therefore the most efficient.

This applies to almost everything in life. I want to, and do value, the time and efforts someone puts into work, but the real value is in the outcome. The best can do it faster AND better.

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If you or a family member has ever had a serious injury or surgery, you may have your own real life example that proves how easily prescription meds are given and how addictive they are. Unfortunately, my own grandmother is a real life example. In the past couple of years, she’s broken her pelvis and multiple back vertebrae — all excruciating breaks. With each break, the hospital over prescribed OxyContin to the point that she was addicted and (literally) seeing bugs on the walls. Twice she had to go through the withdrawal process.  After my grandmother’s first prescription med encounter, she and my family told the doctors what had happened the next time she landed in the hospital. We stated that she did not want powerful, prescription meds this time, but, we discovered, they gave them to her anyway.

The vast majority of these prescriptions are unnecessary.  They’re hurting the health of the patient and driving healthcare costs. The solution to this problem in America? Ultimately, doctors must write fewer scripts and patients must feel empowered enough to question the need for these dangerous and highly addictive meds.  Quality medical care management and utilization review programs can also help curb these incidents of excess with third party nurses and physicians reviewing patient treatment plans.

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This to me was an example of “task management” with all of its flaws — creating rule after rule about every little action a person can take to achieve a desired outcome. I think we can all agree that reducing obesity and diabetes, improving people’s lives, and reducing healthcare costs are all noble goals.  I just don’t think my body and health should be anyone else’s to control.

Just imagine how easy the goal is to circumvent and how hard it is to administer:

• Can people buy two drinks?
• Can they go to two stores side by side?
• Can they mail order two liter sodas?
• Can they drive across the bridge to New Jersey to buy soda in bulk?
• What about unlimited refills?
• What about all other types of sugar? Candy bars?  Desserts?  White flour? All bread?   Fruit? Afterall, too much fructose can mimic soda.

Clearly, to really “control” this issue, the government would need to pass a lot more laws. To make things fair, we’d have to consider everything else that’s bad for our health, like smoking, drinking and fried food.  I would argue that any of these is causing more damage than soft drinks. While Bloomberg’s pet peeve is sugar water, the next mayor’s could be something else. It’s a slippery slope of “task management” once started.

What about other issues that people think are important and are damaging society? Are intelligence and culture important for our children? Why not consider banning reality TV, which often plays to the lowest common denominator of humanity.  People and US magazine really don’t add any value to the intelligence of society.  Instead we should be reading something edifying like the New York Times or Wall Street Journal.  So let’s tax the People and Us readers extra.

You can see where this all leads to:  more and more rules. With additional rules comes people trying to “get away” with things which would require more costs to “manage” an outcome.

Outcome leadership assumes people have an intrinsic incentive to maintain their own bodies and health and we should support them in achieving that goal.  Maybe they’ll get help from a charitable institution with a focus on education and incentives to reduce obesity and diabetes by 25 percent.  Maybe allow the free market to charge more for insurance for people who are not healthy.  Let people choose and teach them how to be successful.

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We’re seeing this trend everywhere. I had a similar experience in Chicago and have helped friends out with the same issue in places like Texas and Florida. This is one of the main reasons 911�Թ�’s Surgical Specialist Network is needed and will help control healthcare costs.

For your own bills, take a look and make sure the doctors office is not billing you like a hospital. If so, you may want to look for a new provider. It costs you (and us) a lot more.

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For those of you who do not know the trends in the industry, hospital groups are consolidating and buying physician practices and Ambulatory Surgery Centers (ASCs). They can charge more for government services than independent groups (Medicare, Medicaid, etc.) so the value of the purchased entity jumps as soon as they purchase it. In addition, with regional monopolistic power, they have more leverage negotiating PPO rates, which drives up costs to the general market.  This trend will continue with the national healthcare law changes.

This is why 911�Թ� has been focused on developing new techniques to attack this problem.   and focusing on has been at the forefront of our product development innovations for the last few years.  Having medical management programs that can impact this trend will become more and more critical as time goes on.

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Many of these programs can automatically generate detailed patient histories, or allow doctors to cut and paste the same examination findings for multiple patients — a practice called “cloning” — with the click of a button or the swipe of a finger on an iPad, making it appear that the physicians conducted more thorough exams than, perhaps, they did.

The New York Times article cites many examples, facts, statistics and studies showing how this catastrophic issue is becoming even more prevalent.  911�Թ� must stay on the look-out for this trend of cloned medical records and patients must start being on the alert for overbilling. One patient in the article took action on an instance of overbilling.  The patient was seen in the emergency room of a Virginia hospital for a kidney stone. When he received the bill from the emergency room doctor, his medical record — produced electronically — reflected a complete physical exam that never happened, allowing the visit to be billed at the highest level.  Ultimately, the only thing that can stop this abuse is more consumer involvement.

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