{ PIAA INTERNATIONAL SECTION CONFERENCE 8-10 OCTOBER 2014 AMSTERDAM | THE NETHERLANDS “The Good, the Bad, and the Ugly” How Threats Can Become Opportunities in Medical Liability PROGRAM www.piaa2014.com Bringing data into focus With so much data and information available, it can be tough to know where to focus. With insight from the largest risk database, Aon Benfield helps clients see more clearly into their risk landscape. Our unique approach together with an understanding of the relevant details, leads to better business outcomes. Contact us today to learn how data can be used to empower your results. aonbenfield.com/empower Empower Results® TABLE OF CONTENTS Page Information on PIAA 2 Sponsors2 Useful Addresses 3 Program Steering Committee 3 Words of Welcome 4 General Information 6 Social Program 7 Program8 - Wednesday, October 8 8 - Thursday, October 9 8 - Friday, October 10 11 If you tweet, please use the hash tag #PIAAIntlConf 1 INFORMATION ON PIAA PIAA PIAA International Section PIAA is the insurance industry trade association that represents a full range of entities doing business in the medical professional liability (MPL) arena. These include U.S.-based and international MPL insurance companies, risk retention groups, captives, trusts, and other entities. PIAA membership is open to MPL enterprises owned and/or operated by physicians, hospitals, health systems, dentists and oral maxillofacial surgeons, podiatrists, chiropractors, and healthcare professionals such as nurse practitioners, nurse midwives, CRNAs, and many others, as well as insurance carriers with a substantial commitment to the MPL line. Members of the PIAA International Section provide MPL insurance and indemnification and related services to healthcare professionals around the world. Based in six nations, their operations include covering parts of Northern Europe, Canada, Australia, the United Kingdom, and other international locations. PIAA members insure more than two-thirds of America’s private practicing physicians as well as dentists, nurses and nurse practitioners, and other healthcare professionals and provide indemnification and other services to more than 400,000 healthcare professionals around the world. PIAA members also insure more than 3,000 hospitals. The sharing of information through PIAA enables members of the International Section to keep apprised of the latest global trends and innovations. The mission of PIAA is to promote, protect, educate, and connect medical professional liability insurers and indemnifiers who support the quality delivery of healthcare and practice of medicine. PIAA’s vision is to be the recognized forum and voice of medical professional liability insurers and indemnifiers. As the world’s foremost industry association specifically addressing medical indemnification, PIAA has comprehensive resources for professional development and education, networking, medical liability research, patient safety, and much more. The PIAA International Conference is held every three years and plays an important role in global information exchange among MPL insurance and indemnification executives and professionals, legal experts, and others with expertise in the MPL arena. For more information on PIAA or the PIAA International Section, go to www.piaa.us. You can also follow PIAA on Twitter: @PIAAKnowsMPL. • Photo credit: Getty Images SPONSORS Over the past 50 years, the insurance and reinsurance industry has seen tremendous changes. From products, services and distribution networks to risk management, capital management and regulation, nothing is how it used to be. Far from slowing down, the pace of this change is accelerating. New technology is having a profound impact on the way in which we assess, model, price and reserve risks. At SCOR, we have the experience and expertise to stay at the cutting edge of these developments. By sharing the art and science of risk with our clients, we can adapt to a changing risk universe together. scor.com 2 The Art & Science of Risk Useful Addresses Conference Venue Renaissance Hotel Kattengat 1 1012 SZ Amsterdam The Netherlands Tel: +31 20 621 22 23 Program Steering Committee Host Organization VvAA Groep B.V. P.O. Box 8153 3503 RD Utrecht The Netherlands E: [email protected] T: +31 247 41 99 · · · · · · · · · · Eric Anderson, PIAA, US Dr. Hayes Whiteside, ProAssurance, US Dr. Doug Bell, CMPA, Canada Herman Falsté, AMMA, Belgium Fernando Mariona, J.D., TPC, Argentina Dr. Matthew Lee, MDU, UK John Tiernan, MPS, UK Prof. René Amalberti, MACSF, France Claire Leonard, MIAA, Australia Harry Henschen, VvAA, the Netherlands 3 WORDS OF WELCOME I am pleased to welcome you to the 2014 PIAA International Conference. Our theme of “The Good, The Bad, and The Ugly: How Threats Can Become Opportunities in Medical Liability” is particularly relevant. In these rapidly changing times, it is our hope that this conference will address both the threats and the opportunities confronting the medical professional liability community. We have asked our speakers to look ahead into this imagined future. We encourage all conference attendees to adopt the same expansive thinking that will produce wide-ranging and spirited discussions about the issues of today and tomorrow. There is certainly much that we can learn from each other about the many medical, legal, and financial challenges. I would like to express my appreciation to our hosts, VvAA and MediRisk. Organizing this event is a major undertaking and all PIAA members are indebted to you. I’d also like to thank the 2014 PIAA International Conference Steering Committee, who developed the excellent conference program. I would further like to recognize the conference sponsors, whose support is important to ensure the conference’s success. Thank you for your generous contributions. We are pleased to be holding this conference in Amsterdam: a truly global city. Our hosts have planned an outstanding program for you to enjoy. I encourage you to explore all this wonderful city and country have to offer. I look forward to meeting and learning from each of you over the next few days. 4 Brian K. Atchinson President and CEO PIAA Welcome to the PIAA International Section Conference 2014, welcome to Amsterdam! It gives me great pleasure to welcome you on behalf of VvAA and MediRisk to the PIAA International Section Conference 2014 in Amsterdam, our beautiful capital of the Netherlands and known as one of the most liberal cities in the world. The PIAA International Conference gets together every three years. The Netherlands also hosted the first International conference back in 1999. Now, 15 years later, in the year that VvAA celebrates its 90th anniversary, we meet again in an historical conference venue, the 17th century Koepelkerk (Domed Church). Herman van Hemsbergen Chairman Executive Board VvAA / Chairman PIAA International Conference 2014 Since 1999, these conferences have brought together hundreds of insurance and medical professionals, all looking to stay informed on global and day-to-day issues facing medical professional liability (MPL) insurers. This edition of the International Section Conference will be all about ‘The Good, the Bad and The Ugly’ in the MPL industry. We will cover trending topics on the broad field of medical liability. More than 150 professionals from all over the world are in attendance and will discuss the international developments so that we can learn from each other. For the first time an International Program Committee was established, containing members from every participating country. As a result we are proud to present this appealing program, which includes international speakers who are proven leaders in their fields. Topics include the use of social media in 21st century medicine, serial claims, the globalization of healthcare and reflections on Alternative Dispute Resolution (ADR). During the closing session, you will get a sneak preview in the future of healthcare. I would like to especially thank Eric Anderson and Bill Burgess for their enormous contribution to the constellation of this program. And please join us at the social gatherings to meet your colleagues and friends. On Wednesday evening, the welcome drinks are served in the Domed Church. After the drinks, you can explore the city and dine in one of the numerous nice restaurants in Amsterdam. On Thursday evening, the traditional conference dinner will be held in The Hermitage Museum. Another special venue in Amsterdam! Do not miss these opportunities to get together with your colleagues. I am happy that you will be a part of this exciting event and share your professional knowledge and experiences with your international colleagues. I wish you an inspiring conference and stay in Amsterdam. 5 GENERAL INFORMATION Registration desk Conference staff The hours of the registration desk are: Date Time Location If you have any questions, the members of the conference staff, who can be recognised by their green badge, will be very pleased to assist you. Please do not hesitate to contact them if you have any questions. Wednesday, October 8, 2014 4:00 p.m. – 8:00 p.m. Hotel Lobby Lost and found Thursday, October 9, 2014 07:30 a.m. – 5:30 p.m. Domed Church Friday, October 10, 2014 07:30 a.m. – 5:30 p.m. Domed Church Please report lost articles to the Registration desk. Medical and Emergency Services Badges Your personal name badge provides access to the sessions and the welcome reception. The different colours on the badge indicates the following: Red = speaker or moderator Yellow = accompanying person Green = staff Certificate of attendance A certificate of attendance will be mailed to you upon request, after the conference. Coffee, tea and meals All official breaks and meals are included in the conference fee. Coffee and tea breaks will be held on the first floor of the Domed Church. Breakfast and lunch on Thursday and Friday will also be served on the first floor of the Domed Church. On Saturday, breakfast will be served in the AmsterdamDen Haag Room. 6 Participants in need of medical treatment should contact the Registration desk. National Emergency Numbers Police, Fire Brigade, Ambulance: 112 National Number Police (no emergency): 0900 8844 Program changes The organizers cannot accept liability for any changes in the program due to external or unforeseen circumstances. Safety Tips As in all major cities, people should be aware of safety risks. It is advised not to wear your name badge outside conference activities. Internet facilities Free Wifi is available in the official conference rooms of the Renaissance Hotel. The code is: PIAA2014 Conference language Insurance and liability The conference language is English. Translation service is not provided. VvAA, PIAA and MediRisk cannot accept any liability for personal injuries or for loss or damage to property belonging to conference participants, either during or as a result of the conference. Please make sure your insurance will cover any hospital or medical services you might require during your stay in the Netherlands. TonyV3112 / Shutterstock.com SOCIAL PROGRAM Welcome reception Conference dinner Date: Wednesday, October 8, 2014. Time: 6:00 – 8:00 p.m. Location: Domed Church, 1st floor Date: Thursday, October 9, 2014. Time: 6:00 – 11:00 p.m. Please use this opportunity to meet the other conference participants. Accompanying persons are also welcome! Please be in the Hotel lobby at 6:00 p.m. in order to depart to the Hermitage. Do not miss out on this evening! Special transportation has been arranged: we will travel by boat to the Hermitage and return by bus to the Renaissance Hotel. Delegates will receive a ticket for the Conference Dinner. If you have misplaced your ticket or have not received the ticket please see the staff at the Registration desk. 7 PROGRAM Wednesday, October 8, 2014 Location 6:00 - 8:00 p.m. Domed Church Welcome reception (included) Thursday, October 9, 2014 7:30 - 8:30 a.m. Breakfast (included) Domed Church, First floor 8:30 - 9:15 a.m. Opening Session Human Factors in Healthcare and Patient Safety Moderator: Herman van Hemsbergen, CEO, VvAA Speaker: Martin Bromiley, Founder and Chair, Clinical Human Factors Group Domed Church A solid understanding of the role that human factors play in adverse events can have a significant impact on patient safety. To achieve this goal, education on the broad diversity of human factors should be included in the core curricula of all healthcare professionals and managers, throughout their initial training and professional lives. It is also essential to develop a culture in which visible leadership creates and promotes strong, respectful, and accountable relationships among all of the stakeholders involved in providing healthcare. Martin Bromiley founded the Clinical Human Factors Group (CHFG) in 2007. CHFG is a broad coalition of healthcare professionals, managers, and users of services who have partnered with experts in human factors from healthcare and other high-risk industries to campaign for change in the United Kingdom’s National Health Service. Mr. Bromiley will discuss human factors from his perspective and address their role in healthcare, patient safety, and medical liability. 9:15 - 10:45 a.m. Plenary Session Serial Claims: When One Event Leads to Many Lawsuits Moderator: Ebbo van Gelderen, Director Non Life Insurance, VvAA Speaker: Professor Han Wansink, Former Faculty, Erasmus University Speaker: Frederic Fuz, Services Division Director, Sham Speaker: Dr. Sharmala Moodley, Deputy Head of Claims, MDU Domed Church This discussion of the challenge of serial claims will include a comprehensive view of the legal issues at stake, and the possible ramifications of such claims. It will also include a detailed case study of a serial claim: its origins, how it was handled, and its aftermath. Finally, the session will explore the insurer’s/indemnifier’s role: the potential impact of serial claims and best practices for handling them. 10:45 - 11:15 a.m. 8 Refreshment Break Domed Church, First floor PROGRAM Location 11:15 a.m. - 12:30 p.m. Plenary Session Disruptive Behavior: Identifying, Measuring, and Addressing Unprofessional Conduct in Healthcare Moderator: Steve Lancken, Mediator, Negocio Resolutions Speaker: Dr. David Blaney, Head of Risk Member Education, MPS Speaker: Anton Westerlaken, Maasstad Hospital Speaker: Andrew Miller, Councillor, MDA National Insurance Pty, Ltd Domed Church This session will explore many of the issues summed up in the phrase, “disruptive doctors.” The speakers will tell how to identify these doctors at the earliest possible point in time, and e xplain how to measure difficult behavior. Attendees will find out why difficult doctors behave as they do, and on that basis, learn the best approaches for remediating this behavior. The speakers will discuss the consequences of disruptive behavior for medical professional liability insurance and indemnification organizations—both direct and indirect impacts. In addition, the speakers will highlight the surprising differences in causes and effects of disruptive doctors for self-employed vs. employed physicians and also provide a doctor’s perspective on this difficult issue. 12:30 - 12:45 p.m. Lunch pickup (return to meeting room for Lunch session) Domed Church, Ground floor 12:45 - 1:45 p.m. Lunch session: The Pervasive Nature and Cost of Defensive Medicine Introduction:Marjoleine van der Zwan, COO, MediRisk Speaker: Dr. Richard Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company Domed Church Nearly all medical care in the United States today is delivered in a liability sensitive context. This phenomenon has made defensive medicine nearly universal throughout the U.S. In this special working lunch session, Dr. Richard Anderson will discuss how defensive medicine is a direct outgrowth of the legal attack on the medical profession over the past four decades and how it has become a fundamental driver of increased costs in U.S. healthcare. Dr. Anderson will discuss the U.S. experience so attendees can identify key points of interest and value in comparison with other countries. 9 PROGRAM Location 1:45 - 3:15 p.m. Plenary Session Electronic Health Records and Other New Media in Healthcare Moderator: Christine Tomkins, Chief Executive, MDU Speaker: Chad P. Brouillard, Esq., Foster & Eldridge, LLP Speaker: Dr. Patrick Ceresia, Managing Director, Corporate Services, CMPA Speaker: Dr. Robert Hendry, Medical Director of Medical Protection, MPS Speaker: Dr. Pierre Campbell, Head of Underwriting, MDU Domed Church The adoption of electronic health records and other electronic media in healthcare is happening at a different pace, and under differing schemes of law and regulation, in the various countries. Each has essential lessons to learn from the others’ experience to date. This session will explore the current and future ramifications of EHRs and other new media for medical professional liability insurance and indemnification enterprises, and explain what companies and their policyholders should bear in mind in doing risk assessment and risk management in regard to new types of exposures from EHRs, mobile healthcare technology, and other new media. 3:15 - 3:45 p.m. Refreshment Break Domed Church, First floor 3:45 - 5:00 p.m. Concurrent Session Improving Diagnoses Through Cognitive Debiasing Moderator: Doug Bell, Associate Executive Director, CMPA Speaker: Velma L. Payne, PhD, Biomedical Informatics Specialist, Micha el E. DeBakey Veterans Affairs Medical Center and The University of Texas Health Science Center at Houston School of Biomedical Informatics Speaker: Laura Zwaan, PhD, Postdoctoral researcher EMGO Institute / VU University medical center Amsterdam Den Haag Room Cognitive biases (distortions of thinking) and affective biases (an intrusion of the physician’s emotions) may interfere significantly in the process of reaching a correct diagnosis. Cognitive biases often adversely influence the rapid intuitive mode of medical reasoning. This case-based session will explore strategies to cognitively “de-bias” clinicians, to help minimize the incidence of diagnostic error. 10 Location 3:45 - 5:00 p.m. Concurrent Session High-Severity Claims: Is the Sky Really the Limit? Moderator: Michel de Ridder, KBS Speaker: Divya Parikh, Director of Research and Risk Management, PIAA Speaker: David Pranklin, Technical Claims Controller, MDU Across the globe, the severity of medical professional liability claims continues to rise. In many c ountries it is not uncommon for judgments or awards to be in seven figures or more. What is driving high-severity claims? Are these claims here to stay? And do these claims have a ceiling in terms of their cost to medical professional liability insurance companies and indemnification organizations? In this session, the speakers will address all of these questions and more. They will examine some of the factors that lead to high-severity claims and offer data that identifies the current specialties and procedures that may be commonly targeted by plaintiff’s attorneys due to their susceptibility to high-value awards. This session will include the presentation of data from the PIAA Data Sharing Project. 6:00 - 11:00 p.m. Conference Dinner (included). See page 6 for details Domed Church Hermitage Museum Friday, October 10, 2014 7:30 - 9:00 a.m. Breakfast (included) Domed Church, First floor 9:00 - 10:30 a.m. Plenary Session Social Media: Friend or Foe in 21st Century Medicine? Moderator: Dr. Hartley S. Stern, CEO, CMPA Speaker: Barbara Ficarra, RN, BSN, MPA, founder Healthin30.com, award-winning broadcast journalist, writer - The Huffington Post, consultant Speaker: Jane O’Brien, former Head of Standards & Ethics, General Medical Council (GMC) Speaker: Chad P. Brouillard, Esq., Foster & Eldridge, LLP Domed Church The phenomenon of social media has taken the world by storm. Healthcare, like every other area of life, has been impacted. This session will provide a broad perspective on all of the factors and issues that medical professional liability insurance and indemnification organizations and individual physicians should bear in mind in using social media. These include potential legal, and new, causes of action for medical liability claims. The speakers will offer some personal insights on best practices in using social media to interact with patients – and what professionals should be wary of as well. They will also provide some informed predictions on the likely role of social media in the future of medicine. 10:30 - 11:00 a.m. Refreshment Break Domed Church, First floor 11 PROGRAM Location 11:00 a.m. - 12:15 p.m. Concurrent Session Alternative Dispute Resolution: Debating the Pros and Cons Moderator: Herman van Hemsbergen, CEO, VvAA Speaker: Steve Lancken, Mediator, Negocio Resolutions Speaker: Domenic Crolla, Esq., Partner, Gowling Lafleur Henderson LLP Domed Church In this session, the speakers will discuss the benefits, and disadvantages, of using alternative dispute resolution (ADR) for resolving medical liability claims. Factors considered include staff time involved and immediate and final costs. Each of the panel members has many years’ experience in using ADR, within the context of the legal and regulatory scheme in his or her country. Attendees will learn which factors make ADR work well – and which, in contrast, make ADR more cumbersome to apply and less effective in holding down costs and making defendant physicians’ lives less burdensome. 11:00 a.m. - 12:15 p.m. Concurrent Session Failure to Diagnose: The Impact on Patients, Physicians, and MPL Entities Moderator: Andrew Boldeman, CEO, Avant Mutual Group Speaker: Helen Vernon, Director of Claims, National Health Service Litigation Authority Speaker: Dr. Hayes V. Whiteside, Medical Director and Senior Vice President, Risk Management, ProAssurance Corporation Speaker: Charlotta Grunewald, Karolinska University Hospital Amsterdam Den Haag Room This session will cover the multiple causes of failure to diagnose, and its many impacts for each of the parties involved in healthcare: doctors, patients, and medical professional liability insurance and indemnification organizations. This session will include data from the PIAA’s Data Sharing Project to help highlight a claims-based foundation for exploring the prevalence of failure to diagnose, and its consequences for physicians, and for medical professional liability insurance and indemnification organizations. Then, a case study will be presented to identify the key factors observed in obstetrical cases that involved failure to diagnose. 12:15 - 1:30 p.m. Networking Lunch Domed Church, First floor 1:30 - 2:45 p.m. Concurrent Session International Claims Trends: Is the Wind Always from the West? Moderator: Gregg Hanson, CEO and President, Coverys Speaker: Kate Gillman, Special Counsel, Medico Legal Advisory and Health Law, Avant Mutual Group Speaker: Dr. Richard E. Anderson, Chairman and CEO, The Doctors Company Speaker: Peter Jeurissen, Ecclesia Gruppe Domed Church This session raises a fascinating question: Where do claims trends originate? Is it always in the West? Or do some new trends in fact begin elsewhere? Three panelists, each from a different PIAA member company, will discuss claims trends as observed in their respective jurisdictions. 12 Location 1:30 - 2:45 p.m. Concurrent Session Public Pressure and Its Influence on Medical Professional Liability Moderator: Ed Amsler, Vice President, MLMIC Speaker: Frank O’Neil, Senior Vice President and Chief Communications Officer, ProAssurance Corporation Speaker: Chris Bronkhorst, LHCS Amsterdam Den Haag Room High-profile medical liability cases often require some level of crisis management. In this session, the speakers will examine the repercussions of high-profile medicalliability cases, from multiple perspectives. They will examine a medical liability case that drew considerable media attention and offer guidance for handling such cases. Attendees will learn how to assess the crisis m anagement situation to determine the threat level to their brand’s reputation, engage negative commenters on social media, employ measurement tactics to assess the impact of their crisis management efforts, develop a post-crisis communications strategy to repair any damage, and much more. 2:45 - 3:15 p.m. Refreshment Break Domed Church, First floor 3:15 - 4:45 p.m. Plenary Session The Future of Healthcare: What Will the Patient Want in 2020? Moderator: Richard Faas, manager Mobile, VvAA Speaker: René Amalberti, MACSF Speaker: Rob de Graaf, senior consultant Product Innovation, Philips Speaker: Adjiedj Bakas, Trend watcher Domed Church What will patients be most concerned about in 20 years? This session tackles that and several other big questions: How will the use of medical apps change the delivery of healthcare? Will robotic s urgery play a bigger part in healthcare? What does the future hold for the process of medical diagnosis? What is the impact of all of these factors on medical professional liability insurance and indemnification organizations? The panelists will discuss these and other topics about the future of medicine. 4:45 p.m. Closing remarks Domed Church 5:00 p.m. Farewell drinks Domed Church, Ground floor 13 www.piaa2014.com
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