F*ck doctors and nurses and their concerns about horrible health IT.
That seems the international standard in 2016 regarding their concerns. There's just too much money to be made in this business to worry about such piddling annoyances as maimed and dead patients.
Doctors, after all, don't know anything about computers, and cybernetic medical experiments on unconsenting human subjects are just good fun.
This new example from Canada:
http://ift.tt/1sVGFD6Who cares what they say? They're just doctors, sayeth the hospital executives..
Nanaimo doctors say electronic health record system unsafe, should be shut down
By Cindy E. Harnett
Victoria Times Colonist
May 27, 2016
Implementation of a $174-million Vancouver Island-wide electronic health record system in Nanaimo Regional General Hospital — set to expand to Victoria by late 2017 — is a huge failure, say senior physicians.
After a year of testing, the new paperless iHealth system rolled out in Nanaimo on March 19. Island Health heralds the system as the first in the province to connect all acute-care and diagnostic services through one electronic patient medical record, the first fully integrated electronic chart in the province.
EHR pioneer Dr. Donald Lindberg, retired head of the U.S. National Library of Medicine, called such total command-and-control systems "grotesque", and that was in 1969 (See http://ift.tt/1vtUMv5). He observed back then:
But he's a doctor too, so what does he know, sayeth the hospital executives.
But nine weeks after startup, physicians in the Nanaimo hospital’s intensive-care and emergency departments reverted to pen and paper this week “out of concern for patient safety.”
Who cares what they say? apparently not the executives, per Toni O'Keeffe, Vice President and Chief, Communications and Public Relations, http://ift.tt/1TTO9z4, as below. The system's perfectly safe!
Doctors said the system is flawed — generating wrong dosages for the most dangerous of drugs, diminishing time for patient consultation, and losing critical information and orders.
“The whole thing is a mess,” said a senior physician. “What you type into the computer is not what comes out the other end.
“It’s unusable and it’s unsafe. I’m surprised they haven’t pulled it. I’ve never seen errors of the kind we are now seeing.”
Doctors are so concerned, they want Island Health to suspend the implementation.
“Take it away and fix it and test it before you bring it back — stop testing it on our people,” said one doctor. “Why wasn’t this introduced in Victoria first? If they went live in Victoria first, they would have a riot.”
(Is there anything unclear there, I ask?)
SHUT UP DOCTORS. IT''S PERFECTLY SAFE, sayeth the administration.
The doctors, who fear reprisals, spoke to the Times Colonist on condition of anonymity.
If doctors did not fear reprisals I'd have a full time job writing on EHR debacles. I could almost have one now.
The $174-million system started with a 10-year, $50-million deal for software and professional services signed in 2013 with Cerner Corporation, a health information technology company headquartered in Kansas City. Thus far, the company has been paid close to $12 million. The remaining $124 million is to be spent by Island Health for hardware, training and operating the system.
I wonder just how much graft there may be, driving what seems an international phenomenon of bad health IT with doctors and nurses complaining (e.g., examples of mayhem at http://ift.tt/14kkNTo), patients being harmed and dying (e.g., ECRI Deep Dive study at http://ift.tt/1pJ8k6H), yet hospital execs and government officials gleefully moving full steam ahead.
The system is being used in Nanaimo’s hospital, Dufferin Place residential care centre (also in Nanaimo), and Oceanside Health Centre in Parksville.
Since March 19, mobile touch-screen computer console carts have been rolling around hospital hallways. Voice-recognition dictation software immediately transcribes a doctor’s verbal notes into a patient’s electronic record, and scanners track each bar-coded patient bracelet around the hospital. But doctors complain the new technology is slow, overly complicated and inefficient.
Today's clinical IT is needlessly and blindingly complex. But hospital executives are, in my increasing view, too ignorant to recognize the necessity of simplicity in critical functions such as clinical medicine. Their jobs are child's play in comparison. (I should know; I once was a health IT executive after having practiced medicine for a number of years.)
“The iHealth computer interface for ordering medications and tests is so poorly designed that not only does it take doctors more than twice as long to enter orders, even with that extra effort, serious errors are occurring on multiple patients every single day,” wrote one physician at the Nanaimo hospital.
In view of current warnings and that which is known, and has been known for many years from the literature about bad health IT, each and every adverse outcome of injury that occurs represents hospital executive gross negligence:
Gross negligence is a conscious and voluntary disregard of the need to use reasonable care, which is likely to cause foreseeable grave injury or harm to persons, property, or both. It is conduct that is extreme when compared with ordinary Negligence, which is a mere failure to exercise reasonable care. http://ift.tt/280hZJu
I leave it to the reader to classify patient deaths.
“Tests are being delayed. Medications are being missed or accidentally discontinued.”
My mother and other patients in whose litigation I have provided informatics expertise were injured and/or died from precisely that type of mistake.
Doctors can’t easily find information entered by nurses, the physician wrote.
There are also complaints about the pharmacy module of Cerner’s integrated system — the only joint build between Island Health and Cerner.
iHealth implementation staff brought in to input orders for physicians this week entered eight drug mistakes on one day and 10 on another, while there were no mistakes in the paper orders, doctors said. “If the experts can’t enter it correctly, what is the average Joe going to do?” one doctor said.
Suffer, and take on all the liability, of course.
Another problem, they said, is patients’ drug orders disappearing from the system.
Australian informatics expert Jon Patrick wrote of such issues in 2011 as at this link: http://ift.tt/1TTOD8t. His technical paper was ignored, and pushback for having written it draconian.
Here's the administration's view:
... But Island Health spokeswoman Antoniette O’Keeffe said the system is safe and doing what it’s intended to do.F*ck the doctors. F*ck the nurses. F*ck the patients.
“We are not going back to paper,” she said. “We can’t go back to paper. We don’t have the mechanics to go back to paper.”
I'll be generous about the stupidity represented by that statement. What she means is, we've jsut blown tens of millions of dollars on computers. We'd get out asses kicked by the Board if we admitted we blew it and went back to paper.
Island Health acknowledges that documentation for staff doing emergency-department patient intake was a challenge, noting Nanaimo is the busiest emergency department on the Island.
A mere "challenge." How about "was not possible in a 24 hour day?"
Nanaimo has some of the top physicians in the country and “we respect the feedback they are giving us, and so we are listening to them and we are tweaking and modifying the system,” O’Keeffe said.
We respect their feedback. They say it should be shut down, but "the system is safe and doing what it’s intended to do."
Challenges include getting medication orders into the system, getting clinical staff trained, work flow and documentation, O’Keeffe said.
More staff have been added to speed up admissions and others are working around the clock in the intensive-care and emergency departments to input handwritten physician orders into the system, O’Keeffe said.
Cerner is working with Island Health staff, “and they’ll be here until we get this fully implemented,” O’Keeffe said.
Ms. O'Keefe. bad health IT is never "fully implemented." (e.g., http://ift.tt/1n4wkwJ) Instead, clinicians learn to work around bad health IT, except when the risk of doing so slips through and patients get maimed or killed.
Island Health credits the system’s electronic warnings for catching about 400 human-caused medication errors and conflicts at three sites, saying it’s a sign that the system is working. It will produce a warning, for example, if the dosage is too high for a patient’s weight, if the drug is not appropriate for a particular disease or if there’s a drug conflict.
Across the country, thousands of medication mistakes are made daily due to human error, “and this system is designed to catch them,” O’Keeffe said.
Doctors respond that so many irrelevant flags pop up, it creates confusion, while the computer loses or duplicates drug orders.
Ms. O'Keefe and her administration are obviously blissfully unaware of how health IT can cause medication errors en masse impossible with paper, e.g., "Lifespan (Rhode Island): Yet another health IT 'glitch' affecting thousands", http://ift.tt/1masIdw. Of course, many hospital executives are ill-informed, lacking the curiosity of the average scientist or physician.
The system was a decade in the making for Island Health. Twenty-three clinical teams were involved in developing various components and there was user-group testing, modifications and feedback, O’Keeffe said. Training has gone on for the last year, she said. “You can only bring a system so far and then you have to put it in a real environment to test it.”
At best - test it - yes, on unsuspecting human subjects known as patients, doctors and nurses. The ones who are harmed and the ones who die are worthy human sacrifice for the glory of computing, eh, Ms. O'Keefe?
At worst - what is wrong with this industry that each and every installation of this technology is an experiment?
Is it that the technology has exceeded the intellectual horsepower of available personnel? In my experience that has seemed to be the case.
By the end of the implementation, it’s expected family doctors will also be able to access patient files started in acute-care settings. Island Health is working on that component now, O’Keeffe said. Once the system is working smoothly in Nanaimo, it will be installed in the north Island and then Victoria hospitals in 12 to 18 months, O’Keeffe said.
Runaway trains cannot be stopped.
Canadian lawyers, take note.
-- SS
from Health Care Renewal http://ift.tt/280i7Jf Murder, Canadian Style: Nanaimo doctors say electronic health record system unsafe, should be shut down, non-medical PR hacks say it's perfectly safeHealthy Care Renewal
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