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grepmeded's profile
GrepMed
GrepMed
GrepMed
@grepmeded

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GrepMed

@grepmeded

Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh

Sacramento, CA
grepmed.com
Joined March 2018

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    1. Adam Rodman‏ @AdamRodmanMD 21 Sep 2019
      • Report Tweet
      • Report NetzDG Violation

      Adam Rodman Retweeted JAMA Network Open

      "These findings raise the possibility that some documentation may not accurately represent physician actions." Interesting study, unsurprising (to me, at least) conclusion.https://twitter.com/JAMANetworkOpen/status/1175213052104454144 …

      Adam Rodman added,

      JAMA Network Open @JAMANetworkOpen
      Case series observing 9 emergency medicine residents shows that 50% of ROS and PE content of physician documentation is inaccurate, likely to fulfill @CMSGov charting requirements. @carlberdahl (on #JNOLive Tuesday at 3 pm cst) https://ja.ma/30dQOjp 
      5 replies 9 retweets 45 likes
    2. Nico Cortes‏Verified account @Cortes_Penfield 21 Sep 2019
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      Replying to @AdamRodmanMD

      Documentation based reimbursement schemes normalize lying in healthcare. Probably not great for our profession or for our patients.

      2 replies 6 retweets 21 likes
    3. GrepMed‏ @grepmeded 21 Sep 2019
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      Replying to @Cortes_Penfield @AdamRodmanMD

      also fear of lawsuits- “if you didn’t document it, it didn’t happen” incentivizes extra aggressive documentation

      1 reply 0 retweets 1 like
    4. Adam Rodman‏ @AdamRodmanMD 21 Sep 2019
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      Replying to @grepmeded @Cortes_Penfield

      Though I have to imagine an inaccurate templated exam hurts more than no exam (such as documenting intact cranial nerves in a patient who has had a stroke).

      2 replies 0 retweets 3 likes
    5. Nick Gowen‏ @nick_gowen 21 Sep 2019
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      Replying to @AdamRodmanMD @grepmeded @Cortes_Penfield

      Yes but fear-driven actions don't have to be effective to be widespread. I think more than fear of lawsuits is fear of being hassled by documentation admin. The arbitrary cms/insurance documentation requirements are the primary driver of these problems.

      1 reply 0 retweets 3 likes
    6. Nick Gowen‏ @nick_gowen 21 Sep 2019
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      Replying to @nick_gowen @AdamRodmanMD and

      At my institution I'm required to ask residents to place addendums to h an ps that don't have "2 in 9" PE coding criteria. It hurts my soul every time, and makes me wonder how our system got so dumb.

      2 replies 0 retweets 2 likes
      GrepMed‏ @grepmeded 21 Sep 2019
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      Replying to @nick_gowen @AdamRodmanMD @Cortes_Penfield

      recently got a call asking me to justify in my note “patient needs to be hospitalized because___”. I guess problem list with hypotension, GIB, thrombocytopenia, and nephro saying may need pressors to tolerate HD wasn’t clear enough? addended my note to avoid a callback

      7:29 PM - 21 Sep 2019
      • 3 Likes
      • GeraldMD Adam Rodman Nick Gowen
      0 replies 0 retweets 3 likes

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