Are we breaking the law?

[lewismug]

I work in I.T. and am fairly new at this hospital. The previous IT guy told me that occasionally, the Medical Records manager would come to him, have him log into our EHR system, and sign orders for lazy doctors who refuse to use the computer, and also delete (cancel) incorrectly entered orders for those same doctors. I was just asked by a nurse to cancel 5 orders for two different patients that have already been discharged. I stalled and told her I would have to figure out how to do it first to give me time for some clarification. Are they breaking the law? Is this wrong? Would I be breaking the law if I made the changes they have requested? I feel it is very wrong and that the hospital administration needs to force these doctors to either use the system or find a new job. How should I proceed?

[HouTx, BSN, MSN, EdD]

You are very wise.

By 'signing' for a physician, you would be effectively practicing medicine without a license. I sincerely doubt whether the physician in question would have your back if a clinical error was discovered... s/he could truthfully say "I did not sign that order" and be completely clear.

I urge you to notify your supervisor and then contact your organization's Compliance Officer ASAP and report these issues - there will be an organizational procedure for this, so just follow the steps as they are outlined. If your supervisor doesn't want you to report it, do it anyway - once you know that this is going on, you HAVE to report it or you are legally complicit. This is (at best) fraud. Practitioners who are participating in it may be open to charges of malpractice/unprofessional conduct by their licensing boards. If it has been an accepted practice, the organization may be vulnerable to accusations of corporate malfeasance. It is a very big deal.

In the meantime, review your organizations policies and procedures to see if these issues are included. If not, it would be a good idea to create some - so that there are clear guidelines from now on.