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Health care is all about health, of course, so changes in health care are going to have a direct impact on the risk manager. The next few years are likely to see some significant changes in medicine that will create new challenges in risk management.
Research into genetics is likely to be a major source of change for the health care risk manager, suggests Fay Rozovsky, JD, MPH, DFASHRM, a risk management consultant in Richmond, VA. Genetics research is yielding more information about what might happen to an individual in the future, and Rozovsky says that is opening up a whole new set of questions for the risk manager to answer.
"Genetics are a big issue, and genetic testing — the use of genetic identifiers — is going to get bigger," she says. "Patients will have a better idea in the not-too-distant future where drugs will have more potent impact on them, whereas doctors used to take a stab in the dark to see which antibiotics would work best for them. That’s good for the patient’s care, but what does it mean in terms of our responsibility?"
For instance, Rozovsky wonders about a situation in which genetic profiling shows that a patient will respond better to a more expensive drug instead of the common ones that most people respond well to. Must the physician disclose that information? What does the physician have to document? Must the hospital maintain a formulary that includes every expensive drug that might be needed by a patient? In some instances, more information will just create more potential liability. Rozovsky predicts that new obligations will emerge as it becomes possible to find answers that previously were unknown.
Other medical developments also could change the face of risk management, she says. Rozovsky suspects that, before too long, there will be a significant change in the way the country handles organ donations. Donations already pose some tricky problems for risk managers, but she says the situation could get more complicated in the future. "Could we possibly get to the point where there is such an exquisite shortage that we see a public policy change where there is a presumption of donation?" she says. "Risk managers would have a field day with the communication issues and the reverse consent issues it raises. We have those issues now, but it would be far more complex."
Look to any medical field, and there are likely to be significant advances in the past 10 years, she says. For perspective, look to the past 10 years and see how much medicine has advanced and how much the risk manager has had to adapt in response. How much of the risk manager’s current work would have been unheard of 10 years ago? A significant part, Rozovsky suggests. "Risk managers have a lot on their plate in terms of keeping pace with some of these innovations," she says. "It’s always been tough to take a medical advance and try to foresee the risk that might be waiting, but that’s what we’ll have to keep doing in the future."