NDA Journal Fall 2024

NDA Journal 8 EHR Copy-and-Paste Can Get Physicians Into Trouble by: Leigh Page, Medscape, April 11, 2024 Physicians who misuse the “copyand-paste” feature in patients’ electronic health records (EHRs) can face serious consequences, including lost hospital privileges, fines, and malpractice lawsuits. In California, a locum tenens physician lost her hospital privileges after repeatedly violating the copy-and-paste policy developed at Santa Rosa Memorial Hospital, Santa Rosa, California. “Her use of copy-and-paste impaired continuity of care,” said Alvin Gore, MD, who was involved in the case as the hospital’s director of utilization management. Gore said the hospital warned the doctor, but she did not change her behavior. He did not identify the physician, citing confidentiality. The case occurred more than five years ago. Since then, several physicians have been called onto the carpet for violations of the policy, but no one else has lost privileges, Gore said. Copy-paste practices can save doctors’ time when dealing with cumbersome EHR systems, but they also can lead to redundant, outdated, or inconsistent information that can compromise patient care, experts said. “EHRs are imperfect, time consuming, and somewhat rigid,” said Robert A. Dowling, MD, a practice management consultant for large medical groups. “If physicians can’t easily figure out a complex system, they’re likely to use a workaround like copy-and-paste.” Copy-and-paste abuse has also led to fines. A six-member cardiology group in Somerville, New Jersey, paid a $422,000 fine to the federal government to settle copy-and-paste charges, following an investigation by the Office of the Inspector General of the Department of Health and Human Services, according to the Report on Medicare Compliance. This big settlement, announced in 2016, is a rare case in which physicians were charged with copyand-paste fraud—intentionally using it to enhance reimbursement. More commonly, Medicare contractors identify physicians who unintentionally received overpayments through sloppy copy-and-paste practices, according to a coding and documentation auditor who worked for ten years at a Medicare contractor in Pennsylvania. Such cases are frequent and are handled confidentially, said the auditor, who asked not to be identified. Practices must return Featured Article

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