Being a target of litigation can push a physician into overdrive in the practice of defensive medicine. "We all practice defensive medicine," Nusbaum says of physicians. "Everybody does it. You have to. How many times I think, 'Look, in all honesty, you don't have to go to the emergency room, but God forbid you would sue me, and I can't diagnose over the phone, so I have to tell you to go to the emergency room.'"
Nusbaum didn't want to keep practicing defensive medicine. And his frustration over the impact of the court case prompted him to develop a mobile app that includes the framework for a legally valid recording of a phone conversation between a patient and a doctor.
The app, known as MedXCom, is designed to record conversations and have them transcribed under a secured portal with HIPAA approvalIn addition, the "patient's whole medical history would be pushed into the smartphone, "Nusbaum says. The app is designated for physicians, but one is scheduled soon for patients as well, he adds. Users are prompted that the calls are being recorded.
"Having a recording of the phone conversations helps make the doctor and patient more accountable," he says. "We are trying to protect both ends, the patient and the doctor. It protects the patients by giving the doctor more and better information to make a good decision. On the doctor's end, there's protection. He can say, 'Look, I told the patient to go to the emergency department and he didn't go.'"
In addition, if a physician fails to give a patient important information, the recording could confirm that, Nusbaum says. "If the doctor didn't do [what he was supposed to do], the recording is there. Then you need to settle the case."
On its website, MedXCom is billed as an upgrade to current communications methods, but one of its main purposes is to derail potential litigation, Nusbaum says. "There's so much spent on defensive medicine; it's so much [a part] of healthcare costs. Anything to improve communication will make a difference."