9075: Risk Reduction Series - Documentation Essentials

Course Description

This course outlines and discusses the essentials and basic principles of documentation to guide physicians and other practitioners to create a more concise, objective, and accurate medical record. Utilizing case examples to illustrate documentation issues which presented challenges to the defensibility of a lawsuit, you will identify documentation strategies to create a more accurate, relevant, and defensible medical record.

Learning Objectives
  1. Utilize documentation strategies to create a more accurate, relevant, and defensible medical record
  2. Identify risks and benefits of electronic medical documentation, including the use of templates, cloned notes, copy and paste, and auto-population
  3. Recognize top documentation issues that have been identified through medical record audits

Credit Awarded

  • 10% Premium Credit for Physician Policyholders
  • 2.0 CME Credits for Physicians
  • Certificate of Participation for Non-Physicians

 

 

 

Course summary
Course opens: 
01/01/2021
Course expires: 
12/31/2023

Faculty & Authors

This course was developed by SVMIC’s Risk Education and Evaluation Department: Shelly Weatherly, JD, VP; Julie Loomis, RN, JD, AVP, Risk Education Program and Development; Jeff Woods, JD, Director of Risk Education Program and Development. Reviewed by Michael A. McAdoo, MD, on September 21, 2020.

CME Information

Accreditation:  This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of Tennessee College of Medicine (UTCOM) and SVMIC.  The UTCOM is accredited by the ACCME to provide continuing medical education for physicians.

AMA Credit Designation:  The UTCOM designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAFP:  The AAFP has reviewed Risk Reduction Series: Documentation Essentials and deemed it acceptable for up to 2.00 Enduring Materials, Self-Study AAFP Prescribed credit. Term of Approval is from 01/01/2023 to 12/31/2023. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AOA:  This program is eligible for two (2) credit hours in Category 2 of the Continuing Medical Education Program of the American Osteopathic Association. Physicians will need to submit a letter of completion from the University of Tennessee directly to the AOA to receive CME credits, or AOA members may self-report the activity.

Continuing Education for Non-Physicians:  The UTCOM will issue Certificates of Participation to non-physicians for participating in this activity and designates it for CEUs using the national standard that 1 hour of educational instruction is awarded .1 CEU.

This activity was released on January 1, 2021 and will expire on December 31, 2023. SVMIC will not process any completions after December 31, 2023.

          

CME Disclosures

No commercial support was received for this activity. No speakers plan to discuss off-label use. No planners or speakers have relevant financial relationships to disclose.

Please login to take this course or register for a login.