Systems issues contribute to malpractice claims, Risk Management executive says.(Practice Trends)

PHILADELPHIA -- There are just as many systems failures at the root of malpractice cases as individual errors or negligence, Dr. Luke Sato said at the annual meeting of the American College of Physicians.

For example, the Risk Management Foundation of the Harvard Medical Institutes Inc., the insurance carrier for 18 hospitals and about 10,000 physicians in the Massachusetts area, has spent nearly the same amount of money over the years on malpractice cases involving clinical support processes as on cases resulting from a problem with the patient-clinician interaction.

"What we see is that this is a process reengineering problem," said Dr. Sato, assistant professor of medicine at Harvard University and chief medical officer and vice president of the Risk Management Foundation.

An analysis of 2,270 malpractice cases within the insurance carrier from September 1995 to August 2005 shows that there are four high-risk categories in their system--obstetrics, surgery, medication-related problems, and diagnosis-related problems.

The diagnosis-related cases are the most prevalent and the most expensive, Dr. Sato said. Those claims usually involve some type of delayed diagnosis, failure in diagnosis, or missed diagnosis, he said.

Dr. Sato advised physicians to take a look at their office processes and set up ways ...