“The notion that EHRs prevent more mistakes than they cause just isn’t proven.”
Computer mistakes like the one that produced incorrect prescriptions for thousands of Rhode Island patients are probably far more common and dangerous than the Obama administration wants you to believe, says Drexel University’s Dr. Scot Silverstein.
Flawed software at Lifespan hospital group printed orders for low-dose, short-acting pills when patients should have been taking stronger, time-release ones, the Providence-based system disclosed in 2011. Lifespan says nobody was harmed….
A growing collection of evidence suggests that poorly designed software can obscure clinical data, generate incorrect treatment orders and cause other problems. Cases include the Lifespan glitch; a data-entry error that led to the 2010 death of a baby at Advocate Lutheran General Hospital in Illinois; and computers at Trinity Health System, a major Midwest chain, that logged doctors’ orders on the wrong patients’ charts.
Computer mistakes voluntarily reported to the Food and Drug Administration include those that researchers said were linked to 44 injuries and six deaths at unidentified institutions. Those problems included tiny fonts causing caregivers to click on the wrong medication; flipped images that led a surgeon to operate on the wrong side of a patient’s head; and lost or misdated test results that caused unnecessary surgery or delayed treatment.
The impact of technological fallacy on human health is such a delicate and scary idea and I am afraid worse fallacies will create worse mistakes in the future, but include state-owned technological management and you are asking for even more error and catastrophic mistakes.
The Lifespan Glitch – Siemens EMR
2010 death of a baby – “an internal investigation at the hospital found that a pharmacy technician entered the wrong value when transcribing a handwritten order into a computer” – Cerner EMR (http://www.informationweek.com/healthcare/electronic-medical-records/emr-safety-in-spotlight-after-babys-deat/231000763)
Trinity CPOE debacle – Cerner EMR again
Before we crucify all EHR systems together, perhaps we should recognize that some are better than others. For instance – Epic. They have over 70 percent of the 66 HIMSS Stage 7 hospitals.
Amen.
Another Obama Care failure.
The failure is when they try to integrate EHR between agencies. That results in a billion dollar mistake. Whoops, good thing they’re not spending their own money.
When I wrote about this, we were mostly speculating that EHRs might cause errors — possibly causing more errors than prevented. In retrospect, this should have been a no-brainer. Complicated, cumbersome systems can cause problems each time they’re used. On the other hand, many of the errors EHRs are designed to prevent occur only occasionally.
“Before we crucify all EHR systems together, perhaps we should recognize that some are better than others.”
From my teaching site at http://www.ischool.drexel.edu/faculty/ssilverstein/cases/:
Good Health IT (“GHIT”) is defined as IT that provides a good user experience, enhances cognitive function, puts essential information as effortlessly as possible into the physician’s hands, keeps eHealth information secure, protects patient privacy and facilitates better practice of medicine and better outcomes.
Bad Health IT (“BHIT”) is defined as IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is lacking in security, compromises patient privacy or otherwise demonstrates suboptimal design and/or implementation.
The problem is, lacking industry transparency, there’s no way to know if EPIC or any other system creates less adverse events and outcomes than the competition.
Who has what % of “stage n” hospitals is irrelevant towards that issue.
The lack of transparency is starting to change – but just starting. Recent ECRI study: http://hcrenewal.blogspot.com/2013/02/ecri-institute-pso-uncovers-health.html
“800 events in 9 weeks of voluntary submissions” – very concerning.