Cures Act: Opening Notes

As patients’ access to their medical information expands, thoughtful attention to what is documented and how patients perceive what they see is an increasingly important component of patient safety and the avoidance of allegations of negligence.

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FAQs About the Cures Act

CRICO’s insights and recommendations are based on a long-term understanding on how medical record documentation impacts patient safety and MPL claims defense, and further informed by our work in support of the OpenNotes movement since 2010.

Cures Act Overview

Eight categories of clinical notes created must be immediately available to patients through a secure online portal. Providers may not block, or delay patients’ access to, any eligible information entered and stored in their EHR. Learn more about this 2021 ruling.

Opening Your Notes: Patient Care Recommendations

Keep these methods of notes documentation in mind when recording your patient encounter. See the list of tips and specific examples.

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Cures Act: Perspectives from Claims and Patient Safety Opening your notes: a patient safety and malpractice claims perspective

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Cures Act: Perspectives from Claims and Patient Safety

April 2, 2021

Looking at the Cures Act and more open notes from both a patient safety and malpractice claims perspective.
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A Failure to Document Patient’s Refusal The medical record is a key witness in medical malpractice suits. Make sure it is complete.

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A Failure to Document Patient’s Refusal

March 25, 2021

Ensure that you document any instances of a patient’s refusal to follow recommendations. Also, find some best practices on how to further educate a patient to follow up with important tests.
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Documentation Dos and Don’ts If it wasn’t documented…

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Documentation Dos and Don’ts

September 15, 2002

Current, complete records which assist diagnosis and treatment, and which communicate pertinent information to other caregivers also provide excellent records for risk management purposes. Missing, incomplete, or illegible documentation can seriously impede patient care and the defense of a malpractice claim, even when the care was appropriate.
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Reducing the Occurrence of Malpractice Cases Involving Insufficient Documentation The odds of a medical professional liability case closing with an indemnity payment increase 76% when there are indications that documentation of patient encounters and care was inadequate to ensure appropriate care by subsequent caregivers, or to guide the patient’s involvement in his or her care decisions.

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Reducing the Occurrence of Malpractice Cases Involving Insufficient Documentation

July 14, 2020

To prevent documentation related cases, consider chart audits along with education regarding what critical information is too often not captured within the patient’s record(s).
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Cures Act: Opening Notes

FAQs About the Cures Act

Cures Act Overview

Opening Your Notes: Patient Care Recommendations

Featured

Cures Act: Perspectives from Claims and Patient Safety

A Failure to Document Patient’s Refusal

Documentation Dos and Don’ts

Reducing the Occurrence of Malpractice Cases Involving Insufficient Documentation