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
.
Who cares what they say? They're just doctors, so sayeth the imperial hospital executives..
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
But he's a doctor too, so what does he know, sayeth the hospital executives.
SHUT UP DOCTORS. IT''S PERFECTLY SAFE, sayeth the administration.
If doctors did not fear reprisals I'd have a full time job writing on EHR debacles. I could almost have one now.
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
), yet hospital execs and government officials gleefully moving full steam ahead.
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.)
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
I leave it to the reader to classify patient deaths.
My mother and other patients in whose litigation I have provided informatics expertise were injured and/or died from
that type of mistake.
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://hcrenewal.blogspot.com/2011/03/on-emr-forensic-evaluation-from-down.html. 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.
To hell with the doctors concerns and with 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://hcrenewal.blogspot.com/2013/11/weve-resolved-6036-issues-and-have-3517.html) 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://hcrenewal.blogspot.com/2011/11/lifespan-rhode-island-yet-another.html. 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
Addendum: An Op-Ed on this matter is here:
http://www.timescolonist.com/opinion/op-ed/comment-new-computer-system-a-detriment-to-health-care-1.2264274 It is grim, written by a doctor under a pseudonym (Dr. Winston Smith is the pseudonym for a doctor in Nanaimo - that says much about fear of retaliation):
One health record. Making care delivery easier for health-care providers. Safer health care. These are the claims Island Health has made publicly for its new electronic health-record system iHealth, introduced initially at Nanaimo Regional General Hospital in March and intended to roll out across Vancouver Island in the coming months.
These are goals physicians share � many of whom enthusiastically use electronic records in their clinics. Despite �bumps in the road,� Island Health claims the implementation of the system is going well.
But these claims are untrue. iHealth does not provide a single health record: It offers no less disjointed and poorly accessible a collection of patient information in differing programs and sites than the previous system.
The system is cumbersome, inefficient, not intuitive � and not simply because it is a new system, but because of its very nature. It�s like trying to make a DOS-based computer work like an Apple or Windows-based system: You can perform many of the same functions, but it is slow, takes multiple steps and is inefficient.
Even the youngest generation, who have grown up with computers, and those with computing science degrees can�t make it work effectively.
The system�s ordering function is faulty and requires multiple separate steps and choices to order a simple medication: A processing issue safety experts know is highly likely to cause error.
And the system sometimes makes default changes in medication orders without the knowledge of the ordering physician. Single orders for medications disappear from the record, so that duplicate orders are initiated by unknowing doctors.
The consequence of these problems is that hospital-based care delivery is slower, more inefficient, more prone to error. Health-care providers are found interacting with their mobile computer monitors in already overcrowded hallways rather than providing direct patient care.
Nurses and doctors have less of a holistic appreciation of their patients and their illnesses because of the disjointed complexity of the electronic record rather than the simple navigability of the previous paper record and charting.
And communication with the computer system has supplanted direct discussion between health-care team members: Like trying to manage complex illnesses through text messages.
Health-care delivery is slower, so surgical operations are cancelled or delayed and patients leave the emergency department without being assessed; patients are not seen in a timely fashion or at all by specialists; medication errors are regular, so patients are medicated inappropriately or even overdosed; and some of our most experienced and valued health-care providers opt for early retirement or leave rather than continue the frustration and moral distress that this system has generated.
And the effect of iHealth is not restricted to the hospital, as some specialists have reduced their outpatient service because of the increased workload iHealth has caused.
In short, health care is not easier or better. The quality of care is worse and access is reduced. Improvements can be made and have been, but the system is fundamentally flawed. The impact on work efficiency and quality will never return to previous levels � a fact even the Island Health iHealth �champions� acknowledge.
Worse, iHealth is unsafe and dangerous. Medicine strives to be evidence-based, but there�s no evidence electronic record systems improve quality of care, and plenty of evidence they do the opposite � particularly this one.
Doctors have expressed their concerns to Island Health. Rather than suspending the system, the health authority�s response has been simply to delay its rollout beyond Nanaimo. It�s OK to let our community suffer while they tinker.
Dr. Brendan Carr, the CEO of Island Health, tells us he�ll �do whatever it takes to make this work,� even while continuing to risk worsening quality of care and expending more of our taxpayer dollars � $200 million so far, a fraction of which applied to delivery of health-care services could provide inordinately better health-care outcomes than any electronic record can do.
The medical community has finally taken matters into our own hands in the interests of patient safety, quality of care and access. A number of departments are refusing to continue using the system and instead returning to the previous one.
Why does Island Health not withdraw this system? In sum, they�ve spent a lot of taxpayers� dollars on iHealth, a product of Cerner, which has been sued by hospital systems in the United States.
And as with many such systems, the objective has not been better patient care, but has been more Orwellian: Improved administrative data and control � no wonder Island Health is loath to give it up.
Well, Dr. Carr, the patient should be paramount. I and my family and my community are not expendable. No electronic record system should be introduced that will not explicitly improve health care, patient safety and access.
Any deterioration in health care is not an acceptable outcome. Suspend the iHealth experiment. Stop wasting taxpayer dollars. Sue for our money back for having been sold a lemon (as other jurisdictions have done).
Spend our tax dollars on services, infrastructure and equipment that will improve health care, not make it worse.
Dr. Winston Smith is the pseudonym for a doctor in Nanaimo.
- See more at: http://www.timescolonist.com/opinion/op-ed/comment-new-computer-system-a-detriment-to-health-care-1.2264274#sthash.rWwQcJZA.dpuf
... The system is cumbersome, inefficient, not intuitive � and not simply because it is a new system, but because of its very nature. It�s like trying to make a DOS-based computer work like an Apple or Windows-based system: You can perform many of the same functions, but it is slow, takes multiple steps and is inefficient.
Even the youngest generation, who have grown up with computers, and those with computing science degrees can�t make it work effectively.
The system�s ordering function is faulty and requires multiple separate steps and choices to order a simple medication: A processing issue safety experts know is highly likely to cause error.
And the system sometimes makes default changes in medication orders without the knowledge of the ordering physician. Single orders for medications disappear from the record, so that duplicate orders are initiated by unknowing doctors.
Deadly.
The consequence of these problems is that hospital-based care delivery is slower, more inefficient, more prone to error. Health-care providers are found interacting with their mobile computer monitors in already overcrowded hallways rather than providing direct patient care.
This was not what the pioneers intended.
Nurses and doctors have less of a holistic appreciation of their patients and their illnesses because of the disjointed complexity of the electronic record rather than the simple navigability of the previous paper record and charting.
That sums up a major problem with today's health IT well.
The medical community has finally taken matters into our own hands in the interests of patient safety, quality of care and access. A number of departments are refusing to continue using the system and instead returning to the previous one.
This type of revolt, showing who really owns the hospital, needs to become commonplace.
Why does Island Health not withdraw this system? In sum, they�ve spent a lot of taxpayers� dollars on iHealth, a product of Cerner, which has been sued by hospital systems in the United States.
And as with many such systems, the objective has not been better patient care, but has been more Orwellian: Improved administrative data and control � no wonder Island Health is loath to give it up.
Indeed.
The CEO is himself a physician:
Well, Dr. Carr, the patient should be paramount. I and my family and my community are not expendable. No electronic record system should be introduced that will not explicitly improve health care, patient safety and access.
This anonymous doctor needs to speak to my mother, who I visited yesterday along with my father, on U.S. Memorial Day - at the cemetery after her encounter with bad health IT.
Read the whole Op Ed at the link above.
-- SS
New computer system a detriment to health care
New computer system a detriment to health care
