Using evidence-based strategies to help reduce malpractice risk

Busy clinicians need proactive outreach

We knew simply providing useful content and tools to our physicians wasn’t going to be enough to capture their attention and help them feel secure and mitigate risk in the long run.

We have 40 years of claims data on over 100,000 claims. Additionally, we have gone through the medical records, analysis and evaluations of those outcomes from physicians, depositions, and trial testimony to cut down to the granular detail as to why individuals in more than 20 specialties have ended up in a courtroom. More importantly, we’ve taken those loss drivers and applied them to actionable strategies to help prevent a similar outcome in the future. We are trying to be very intentional with our evidence-based content and provide clinicians something distinctly useful they can’t find from another source.

Nonetheless, as Poling points out, “it’s not realistic to hope that they have time to check their email that night and they happen to open one from MagMutual and click through to read an article that just happens to be relevant the next day when they’re with a patient. Getting digestible personalized knowledge that’s relevant to them in a way that’s time-efficient is just as important as what is being shared.”

Experimenting with workflow integration: UpToDate alongside risk data

With our policyholders already affirming their belief in the value of UpToDate for daily clinical usage and supporting decision-making, we saw it as an opportunity to experiment with ways to augment the advice our team offers.

“The more we can get our advice into their daily routine and workflow, the more we think they’re going to be receiving it,” Poling says.

By integrating our risk strategy information and advice with UpToDate clinical decision support, we’re able to offer our policyholders a resource that is unique in the industry. Without having to do anything extra, when they search for information on specific conditions in UpToDate as part of their daily workflow, when relevant, the results will also yield a sidebar box indicating there are MagMutual risk mitigation recommendations or care strategies alongside UpToDate’s industry-leading medical knowledge and evidence-based recommendations. The clinicians can choose to click through to learn more about the potential risk drivers associated with the condition they are researching, but even if they don’t, the box itself acts as a potential warning for increased risks giving clinicians a chance to be more mindful.

As an example, if a policyholder physician looks up vertigo, which can be caused by benign things, they will be able to see all of the most current best practices and recommendations typically provided by the UpToDate resource. Likely it will be a benign cause at the root of their patient’s problem. However, the risk mitigation strategies in the sidebar will also highlight the rarer possibility in the literature to note that the physician might consider cerebrovascular accident as a cause for vertigo. This is not to steer the clinician to a diagnosis; it is just to raise awareness of the commonly missed risk and allow them to consider it among their diagnostic possibilities.

Prior to this integration, the MagMutual platform presented itself to policyholders with a “somewhat passive approach,” Poling explains. “We’re partnering with UpToDate as a first step to proactively push personalized advice to clinicians so they’re not having to come and seek it out.”

Confidence in decisions improves with access to evidence

In 2023, MagMutual launched two experiments in which policyholders were given access to UpToDate integrated with the MagMutual content for certain search expressions. Over 100,000 searches returned the relevant content in the first 90 days.

In surveys to these early users:

• 77% said the MagMutual content would help them better understand and mitigate risks.
• 64% liked the presentation of the information.
• 63% felt the content would help them improve patient care.
• 72% said they would be likely to take action based on viewing content within UpToDate.

As we continue to expand access to more policyholders, we will also look to continue to enhance the user experience. We plan to incorporate user feedback from these surveys to guide us as we examine ways to optimize the design and delivery of information.

Moving forward, we hope to connect more policyholders to relevant topic specialties based on their usage within UpToDate.

“We have risk drivers targeted by specialty. We’re working to get risk drivers by the procedures and the diagnosis as well,” explains Szuda. “That would be a lot more granular to what the physicians and other providers need. We want to make sure that we’re providing them the content that’s relevant to them and we’re getting more specific with risk reduction strategies.”

“We know the effectiveness of advice is maximized when it’s actionable, relevant, and delivered at the time of care,” Poling says. “That’s why we’re combining our technology innovation, data, and analytics with a highly regarded physician-centric channel like UpToDate to offer information to our providers when it will be most useful, changing the practice environment and patient outcomes for the better.”