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Poor patient records fuel alarming increase in medical malpractice suits

08 Oct 2019

Public sector healthcare departments face a mountain of medical malpractice claims and are rendered defenceless by poor record keeping.

Government health departments are being put at significant risk by the increasing number of medical malpractice claims and technology could just stem the tide. A 2018 study by SECTION 27’s budget analyst Daniel McLaren quoted in the Daily Maverick[1] revealed that, in the Eastern Cape alone, accumulated claims totalled R24.1 billion, of which about one third were incurred in 2018. In addition, malpractice claims totalled R24 billion in Gauteng and R16.3 billion in Kwa-Zulu Natal. In just six[2] of the country’s nine provinces, total claims in 2018 amounted to over R69 billion.

According to Andrew Davies, CEO of Healthcent, which has developed the Signapps™ mobile messaging platform for the healthcare sector, the absence of, or difficulty in obtaining, critical patient records timeously, renders state health departments defenceless against the swelling tide of medico legal claims.

“The financial risks these pose to provincial departments of health are huge. Were these claims to be paid out, the ability of these departments to continue to serve their communities would be brought into question,” he said.

The spike in malpractice suits involving public hospitals says Davies, is being fueled by experts in the legal fraternity who are taking patient cases on a no-win-no-fee basis.

Most of these claims according to Davies, involve children with cerebral palsy, allegedly caused by negligence and clinical mistakes made during the birth process. Such mistakes can leave children permanently disabled, causing untold hardship for the parents and a large cost burden throughout the child’s life. These costs are largely borne by the State.

“Given the absence of reliable medical records or a way of quickly retrieving such, hospitals simply do not have access to reliable information and a credible paper trail with which to defend themselves. This inhibits the ability of the state to process legitimate claims speedily and block fraudulent claims, which comes with its own costs,” he said.

According to an experienced medical malpractice defence attorney, where patient records are not properly created and stored safely, or are not capable of being produced efficiently, it is more difficult for a defendant medical practitioner or health institution to conduct a defence to a claim.

“In the same vein, any application or methodology which enables medical practitioners and institutions involved in the treatment of a patient to communicate with each other more clearly, efficiently and confidentially, in my experience, enhances patient safety and the quality of care,” he adds.

While Healthcent’s Signapps™ mobile messaging platform has no influence on the clinical process, it provides a simple mechanism whereby patient-related information can be easily and reliably recorded, stored and retrieved and shared within a secure group of medical practitioners.

International studies have revealed that as much as 70% of all preventable mishaps in healthcare happen as a result of miscommunication or no communication. Using Signapps™ medical files and updates can be recorded and shared confidentially, enabling appropriate responses by providers.

“The best outcome is to use technology to mitigate the adverse event for the patient in the first instance through better communication and care coordination,” says Davies.

The system is also compliant with POPI, National Health and HPCSA regulations.

“For state hospitals, a key value-add is the fact that all patient records are also stored in the cloud and can be retrieved in the case of a malpractice suit,” Davies said.

Already Signapps™ is being used by both the public and private sector alike in South Africa. Healthcent has over 35 customers comprising hospitals (public and private) and hospital groups, practices, associations and funders of care. There are over 2000 users registered on the platform.

Most notably it is being used in the children’s burns units in Baragwanath, Edendale and Red Cross Hospitals because of its suitability to store and transfer images, vital to the care of burns victims.

Using Signapps™, multi-disciplinary teams within the burns units can conduct conversations, share medical files and updates easily and confidentially, from any mobile device. This cuts down on costly consultation time and ultimately drives better outcomes for patients.

“Our objective with Signapps™ is to transform how patients are cared for in South Africa. Our aim is to be the simplest, most effective, care co-ordination platform for people and organisations in the healthcare ecosystem, and to ensure that the patient remains firmly at the centre of the treatment universe,” Davies said.

While Davies acknowledges the pervasive incorporation of Signapps™ within the state healthcare system may be more complex, it does not mean it should not be considered.

“The downside for provincial health departments is far too dire for that,” said Davies.

To underline this, a case brought by the mother of a cerebral palsy child ended up in the Supreme Court of Appeal, where the learned judges have ordered the Health Minister to urgently “address … serious and serial negligence in hospitals falling under the Eastern Cape Health Department.”

Whether or not provincial health departments are able to make a significant difference to the standards of medical care in the field of obstetrics, one thing is clear: that the use of technology, such as Signapps, has the potential to improve outcomes for patients and at the same time put the state in a position to defend lawsuits timeously and cost effectively.

[1] Daily Maverick: “A tragedy that’s indicative of SA’s failing health systems” by Mark Heywood, 21 August, 2019.
[2] Figures for Mpumalanga, North West and Northern Cape were not available.