Are you prepared?

You never know what tomorrow will bring. Anyone’s personal health history can change at any given time, but as we get older or our loved ones get older, the chance of this happening becomes more significant. Statistics from the National Council on Aging tell us, 92% of all retired age people will, at some point, have at least one chronic disease, and 77% will have at least two.  

If you can lessen the load for your loved ones down the road, wouldn’t you be willing to get their medical records organized, so you have the critical information at your fingertips when there is a medical crisis. R&G Medical Legal Solutions has developed a factual, chronological medical history customized for you or your loved one.  

Some items for consideration: 

  • If your loved one was incapacitated today – would you know what medications they take, the dose and when they started taking it, and why they are taking the medicines?  
  • Are you overwhelmed with multiple records filled with treatments or procedures? 
  • Can you or your loved one access or navigate their doctor portals? 
  • Would you know what allergies a new doctor should be aware of to minimize any complications or interactions?  
  • When was their last surgery? 
  • If you have this information, is it current?  
  • Is the information somewhere secure and available to you when you need it most?  

R&G Medical Legal Solutions has developed an innovative Personal Medical Profile with one basic idea in mind: a vital document for continuity of care or medical crisis. Don’t leave your caregiver or loved ones guessing.   

Our Personal Medical Profile is an easy-to-read, factual document for you to access or share with your physicians, healthcare proxy, or family members of your choice. All vital information will be outlined on the first page, followed by individual doctors’ visits, facilities, or hospital admissions. Our Personal Medical Profile has a minimal fee to get started, and all plans are subscription-based depending on the level of care your loved one receives. We will update the profile when you notify us of a new medical visit or admission. You will always be up to date to be the best advocate for your loved one. 

Whether you work with us or not, we encourage you to have this vital document. Please click here if you would like more information on the Personal Medical Profile from R&G Medical Legal Solutions. 

Coordinating Care for a Loved One from Afar

Being involved in the care of a loved one can be both rewarding and joyful. Providing love, physical and emotional support along with companionship is a noble thing to do. Some acts of caregiving are easier than others. Coordination of medical care is one of the more challenging tasks. Many caregivers find this aspect time-consuming and frustrating. For example, managing medication refills, follow-up appointments, and post-visit instructions can be overwhelming.

Sometimes a loved one can have difficulty articulating their complex medical history to a new medical team member. The caregiver is often called upon to assist. A chronological document that outlines the loved one’s past medical history can make health appointments much easier in terms of providing medical information efficiently. A computerized document is recommended given the ability to edit /update information. For example, the weight of the loved one may fluctuate. However, not everyone has access to a computer therefore a handwritten history will suffice.

As a layperson knowing what aspect of medical history to document is a challenge. For example, is there a need to document medications the loved one no longer takes? Why are height and weight important? Should every medical appointment be logged are a few questions to consider.

Below is a suggestion of important historical information to consider. If dates of diagnosis are known, include.

·      Name and date of birth

·      Do you know the patient’s height and weight?

·      Do you know important blood relative family health history (any significant medical history such as heart, lung, cancers, mental health disease)?

·      Are you aware of all past surgeries including dates and reasons?

·      Any past hospitalizations? Also to include reasons and dates.

·      Any chronic and ongoing medical history to include cancer, heart disease, diabetes, high blood pressure, high cholesterol, kidney disease, chronic

pain?

·      What are the current medications and dosages? Include medications recently stopped taking, including supplements and over the counter.

Information contained in the document is meant to be helpful to a medical team member, if there is other information the caregiver believes is important and significant, it should be included.

In sum, a well-written document containing significant medical history can assist a care provider working with the loved one’s medical team. The document is meant to be flexible in that information may be added or sometimes even removed. The document should be taken to each health care appointment.

R&G Medical Legal Solutions, LLC is rolling out a new program related to providing clients with a “Personal Medical Profile”. Please visit our website at www.rngmedcons.com/pmp for more information.

Personal Medical Profile

Do you take care of any family members, and not know their medical history?

Overwhelmed with multiple records to keep track of treatments or procedures?

Do you or someone you know have a complex medical history?

If you answered “yes” to any of these questions, R&G can help! R&G has recently launched a new service called “Personal Medical Profile”.

R&G will provide your medical information in one easy to read factual document, that can be used for sharing with a new healthcare provider, family member, or caregiver.

If you have any questions or would like to hear more, call us today at 1-623-566-3333.

Assisting with the Care of a Loved One – What does Care Mean?

It is not uncommon to have to assist aging loved ones with their care from time to time. Our loved ones are “family,” and we want them to be healthy, safe, and comfortable. Moving into the role of the caregiver may be sudden or unexpected. With elders, it generally begins as part-time caregiving responsibility but can progress to a time-consuming activity, eventually becoming an overwhelming role. Over time, the caregiver may develop feelings of resentment and compassion fatigue, which in turn leads to guilt and shame for both parties. 

Many variables go into assisting with care. Honest and clear communication with the loved one can often clarify needs and expectations, which will decrease disagreements and arguments. For example, what does “care” really mean to the loved one? Do they want/need simple reminders concerning medication? Can they make their own appointments and drive themselves? Do they need housekeeping assistance? How about help with bathing and grooming? Conversations around these subjects may be awkward. The loved one may be in denial about needing assistance or be ashamed to ask for help. The caregiver may not realize how much help is needed or may overstep boundaries. The concept of “care” should be congruent between the loved one and the care provider. Otherwise, untoward issues may arise. 

Quality of life is a suggested area of the initial discussion. What does the quality of life mean to the loved one? Do they have preferred activities that bring them immense joy? What would create misery in their daily life if they were unable to participate? It is a critical area of discussion because the quality of life is tied directly to the loved one’s goals. Missing out on this crucial conversation before a caregiving arrangement is made can build a wall between the loved one and the caregiver and cause bad feelings.  

A good place to start in terms of a conversation with a loved one needing care is exploring what their daily goals are and what “care” means to them. Most people will agree that the goal of care is to assist another person in living as independently as possible. Harder conversations include where the care takes place, who provides the care, and the frequency. 

Exploring daily and monthly routines is essential when determining caregiving needs. Is the living environment clean and safe? Are finances managed adequately? When do meal preparation/eating, dressing, bathing, toileting occur? How easily are the activities of daily living accomplished independently? How are groceries and medications obtained? Are treatments for specific health conditions required? Answers to these questions provide a general understanding of the loved one’s needs. 

Respecting the rights and the autonomy of the loved one is key to building a solid foundation for care. Controlling, rigid, and dictating behaviors on the part of the caregiver can be demoralizing for the loved one.  

Taking on the role of caregiver for a loved one can be both rewarding and anxiety-inducing. The likelihood of a successful partnership is based on honest and clear communication regarding expectations. Ask them about their goals, what “care” means to them, things that enhance their quality of life, and what their daily routines look like. To reiterate, consider the rights and autonomy of your loved one when providing care. Remember you are not alone!  

Medical Abbreviations

The use of medical abbreviations has been used since the development of medicine and is a longstanding practice. They are thought to save time and space when writing medical records. Additionally, they are cost effective and can be customized. While many healthcare facilities have gone to electronic records, the practice of handwritten records still exists, thus the continuance of handwritten medical abbreviations.  

Paper records are prone to errors. Illegible writing causes confusion and at times, a delay in care due to a need for follow up with the author for clarification; especially when it comes to medication orders and dispensing. Many abbreviations may have more than one meaning and the staff interpreting the record may not be familiar with the abbreviation being used.  

In 2005 The Joint Commission, an enterprise that accredits and certifies healthcare organizations, adopted a list that is forbidden to be used by Joint Commission accredited facilities. Below is the list along with an explanation of the potential problem.  

*DO NOT USE POTENTIAL PROBLEM USE INSTEAD  
U, u Mistaken for “0” (zero), the number “4” (four) or cc Write “unit” 
IU (international unit) Mistaken for IV (intravenous) or the number ten (10) Write “International Unit” 
Q.D., QD, q.d., qd (daily)   Mistaken for each other  Write ‘daily” 
Q.O. D., QOD, q.o.d., qod Period after the Q mistaken for “I” and the “O” mistaken for “I” Write “every other day” 
Trailing zero (X.o mg) (Applies to medication orders) Decimal point is missed  Write X mg Write 0.X mg 
MS     MSO4 and MgSo4 Can mean Morphine Sulfate or Magnesium Sulfate   Confused for one another  Write “morphine sulfate” Write “magnesium sulfate” 

 2020 The Joint Commission Fact Sheet 

*List does not apply to preprogrammed health information technology systems.  

The Joint Commission has made a recommendation to not sure the symbols for “greater than” or “less than” as they may be interpreted for the letter L or the number 7. The symbol for at (@) is discouraged because it may be misinterpreted as the number 2. Instead, providers should write out the words, “greater than”, “less than” or “at” as they appropriately apply in the chart.  

Misinterpretation of abbreviations may result in patient harm to include death. R&G nurses are skilled at reading handwritten records and recognized when a contributing error has occurred. If you are an attorney and need help with your case, please contact R&G at 1-888-486-2245. 

R&G LNC Services

Legal Nurse Consultant -AALNC

R&G provides services to firms of all sizes.  Services are performed by US-based registered nurses who possess both clinical nursing experience and specialized legal training. Effective partnerships between R&G and clients are facilitated through the use of Project Managers who ensure timely delivery of work products. 

Though not required, clients and Project Managers use R&G’s proprietary, secure, legal case management system with a built in DICOM viewer, to monitor project progress in real time, with the ability to access finished work products, anytime, anywhere.  All work products are customizable to meet the needs of the clients.

We use US-based Legal Nurse Analysts working in a secure virtual environment. We also offer our clients Virtual Legal Nurse Associates. R&G will match a highly experienced and appropriately specialized LNC to your case.  The nurse can work either on a short term or long term basis.  Client’s have direct access to their assigned nurse in order to facilitate communication.

Give us a call today to discuss your case needs!

Phone: 1-888-486-2245

Email: rngrfp@rngmedical.com

Your Trusted Legal Solutions, On Time, On Target, On Task

Outsourcing Record Retrieval Pays Off

RNG Medical Records

Medical records play a key role in a variety of legal cases and insurance claims. Retrieving medical records when putting together a case has always been a laborious task, with requests typically taking up to a month to complete. It can get costly too, not just because you usually must pay for each record, but also because it can take multiple working hours to prepare and submit requests, as well as track progress. You need all the time you can get to put together a compelling case, but if a lot of that time is being spent on retrieving important documents, then it will not take long before the costs start piling up and delays become a part of the process. 

Consider the following breakdown of this best-case scenario of retrieving records and billing statements:

In House Record Retrieval

Processing Paperwork for Request15 minutes
Faxing or Mailing Paperwork20 minutes
Follow Up with the Provider (3 follow-ups at 10 minutes per follow up)30 minutes
Paying & Tracking the Invoice15 minutes
Reviewing & Scanning Records30 minutes
Total1 hour 50 minutes
Legal Assistant US Avg: $18.34/hour$34.84
Taxes, Equipment, Operating, Insurance, Benefits: 30%$10.45
Total$45.29

This is a best-case scenario of how the entire process plays out and the actual time your staff spends on getting records from the provider. Mind you, this is the best-case scenario. What happens if the request is lost by the provider? Documents are incorrect? The provider takes 10 phone calls before they will send the records. Let us look at additional tasks and issues that arise that can take up hours:

Tasks Requiring Additional Time

Re-submitting a Request10 minutes$3.00
Resending Paperwork10 minutes$3.00
Each Additional Follow Up10 minutes$3.00
Receive Wrong Records
Reach Back Out to Get Corrected
30 minutes$7.80
Affidavit (filling out, quality checking, etc.)30 minutes$7.80
Setting Up Courier Service30 minutes$7.80
Coordinating Courier Service (average 3 visits to provider)60 minutes$15.60

If you must re-submit the request, have 6 extra follow-up calls, and must reach back out to get an affidavit corrected you have just added $48 of expenses for a total of approximately $93.29 for just one request.

By using R&G Medical Legal Solutions, all tasks having to do with managing the retrieval process fall on R&G. The only tasks needed to be done by the firm are submitting the request and providing us with any necessary documents. It is as easy as that!

On top of a budget-friendly process, we have a secure Online Legal Case Management Database System (LCMS) providing anytime-anywhere access to case details, retrieved medical records, and completed work products.  R&Gs secure, online picture archiving and communication system (PACs) allows clients and/or their Expert Witnesses to view radiology images in one location, online, in lieu of pdf/jpeg copies. Digital Imaging and Communications in Medicine (DICOM) features such as video imaging and panning and digital measuring tools are included in the viewer. There are no additional fees associated with access. 

All of R&G’s medical-legal consulting or document management clients can:

  • Track case deadlines and status of records in real-time
  • Access medical records and completed work products
  • Data is safe and private!  LCMS uses BOTH redundant storage (to protect your data in real-time) AND frequent backups (to protect data in case of disaster)

Please call us at 623-566-3333 to get a free quote today. We can’t wait to hear from you!

Medical Cannabis

Medical Cannabis

Medical cannabis remains a controversial topic throughout the United States as many states are repealing associated restrictions. Both recreational and medicinal cannabis is now available in a handful of states.  Despite the growing research supporting cannabis as a pain management and rehabilitation tool, the federal government continues to classify cannabis as a Schedule 1 drug. This makes cannabis federally illegal, as well as limits medical studies that would better explore the benefits. 

Cannabis and cannabis derivatives are used to treat the symptoms of many ailments and illnesses, such as cancer, PTSD, AIDS, epilepsy, and more.  According to a 2017 study published in Cancer Chemotherapy and Pharmacology, pharmaceutical cannabis can decrease nausea caused by chemotherapy and almost eliminate vomiting. Cannabis has also been found to relieve the spasticity of the muscles that is sometimes associated with multiple sclerosis and can help treat appetite loss and “wasting” associated with conditions such as HIV/AIDS and certain types of cancers. One chemical compound of the cannabis plant, Cannabidiol (CBD), has been used to treat and reduce seizures in people with epilepsy (specifically Lennox-Gastaut syndrome and Dravet syndrome). Cannabis is used to treat chronic pain, and in some cases may be used instead of opioids for pain management. (Opioids are highly addictive and are typically not recommended for long-term use in treating chronic pain.)  Cannabis may also be beneficial in symptom management of some mental health conditions, such as PTSD.

While there are many benefits to using cannabis, there is still much we do not know about this plant and its long-term usage. For example, studies have shown that frequent use may seriously affect short-term memory, as well as impair cognitive ability. While there are many ways to ingest cannabis, smoking anything can seriously damage your lung tissue. Immediate side effects of cannabis use may include paranoia, elevated heart rate, anxiety, and impaired motor function.  Long-term effects may include mood swings, lung infections, panic attacks, and memory loss.  Signs of impairment may include red eyes, delayed reaction time, poor hand-eye coordination, lack of concentration, and decreased perception of time and distance.

Cannabis has been implicated in a high percentage of automobile crashes and workplace accidents. A review of the medical record and summary of care often provides insight into the extent and timing of cannabis use in relation to a mishap.  R&G is here to help with reviews of cases involving cannabis.  Please call 623-566-3333 or 1-888-486-2245 for more information about case reviews. 

Virtual Nurse Associate

Virtual Nurse Associate

What is a virtual nurse associate?  
A virtual associate is an independent contract worker who works remotely in support of clients nationally. Typical tasks include administrative, technical, and business support services. Legal Nurse Consultants are well suited to work in a similar capacity serving law firms who may need assistance on a regular or per diem basis. This allows firms to scale staffing to their immediate needs and “right-size” when/if workflow subsides.  

What does a virtual office assistant do?  
Virtual nurse associates do many things including records analysis, case summaries, chronologies, identifying missing records and/or gaps in care, as well as identifying experts. A virtual nurse can do almost anything an in-house nurse can do. A virtual nurse associate can easily maintain office hours consistent with their clients or work in an asynchronous fashion, whichever benefits the client the most.   

Skills Set of a Virtual Nurse Associate  

Working virtually can be a challenge and is not a good fit for everyone.   Some people find working remotely to be isolating and stressful and prefer to work in an office environment.  Nurses are adaptable and are well suited to virtual work.  Characteristics of most nurses include:  

  • Self-starter 
  • Ability to set and see goals through fruition. 
  • Able to manage multiple competing priorities. 
  • Problem-solving skills.  
  • Excellent oral and written communication skills  

Benefits of Working with a Virtual Nurse Associate  

Communication virtually with a nurse associate need not be a challenge. The nurse can adapt their online hours to match that of the client. Should short notice taskings arise the nurse is available, just as an in-house nurse would be.  

Working with a virtual nurse associate is cost-effective in that they can be used as much or as little as needed. No doubt this model increases profits for firms. For example, the nurse could be used for a working surge before trial. If a client needs to “right-size,” no-layoff will occur as the nurse is an independent contractor without any benefits typical of an employee. The Virtual Nurse Associate does not require other benefits from their clients such as sick time, paid time off, vacation time, health insurance, or retirement benefits.  

A virtual nurse is an excellent fit for a firm who is searching for their “best fit” but needs assistance in the interim. If a less experienced nurse is hired, a virtual nurse could also serve as a mentor to the new nurse. Should the new nurse turn out not to be the best fit, the virtual nurse continues to service the firm seamlessly.  

R&G Medical Legal Solutions, LLC has a virtual nurse program, and no job is too big or too small. R&G nurses have a wide variety of backgrounds to include medical-surgical, emergency department, critical care, and long-term care, just to name a few. This allows firms to take a variety of cases knowing R&G can match the virtual nurse to the background of the case. Please contact Pamela Showers, COO at 623-566-3333 for rates and any questions.