Friday, December 05, 2014

I Would Really Like People To Make Claims For Health IT Outcomes After They Are Proven, Not Hoped For!

This appeared last week:

St Stephen's Hospital's digital system on show

Carlie Walker | 27th Nov 2014 4:00 PM
DELEGATES from major private and public hospitals throughout Australia are visiting St Stephen's Hospital in Hervey Bay this week, keen to learn the secrets of efficiency and improved care unlocked by the hospital's digital system.
Richard Royle, executive director of UnitingCare Health, said the state-of-the-art facility had impressed those gathered so far during the three-day event, with delegates from hospitals, banks and the CSIRO anxious to see the system in practice.
"It's terrific for the Fraser Coast," he said.
Mr Royle said because information was recorded directly into an online electronic system, it virtually eliminated the chances of the wrong treatment being given to patients.
Because nurses were not tied down with paperwork or trying to decipher handwritten notes, prescriptions or instructions, that freed them up to spend more time with patients, which was a major benefit, Mr Royle said.
Mr Royle said all equipment in the hospital had a GPS tracker attached, where if a nurse needed to track a wheelchair, they needed only check the location of the GPS device, eliminating the need for them to search for equipment.
Mr Royle said mistakes were made in every hospital throughout the world, but the system in place at St Stephens went a long way to eliminating human error.
Errors could no longer be made by misinterpreting handwriting on prescriptions because all information was recorded digitally.
Each patient was also given a barcode and the barcode was used to digitally record any allergies the patient might have and exactly the prescription they needed.
If a doctor tried to prescribe a drug that the patient was allergic to, an alarm would sound when it was scanned into the digital system, Mr Royle said.
Lots more here:
When you read things like this you really have to wonder:
“Mr Royle said because information was recorded directly into an online electronic system, it virtually eliminated the chances of the wrong treatment being given to patients.”
Of course error reduction relies on the clinician ordering quality as much as it relies on quality information flows.
Equally the time spent in data entry can easily be as long as hand-writing notes - albeit there are real benefits for spending the time.
What I would like to see is some before after snapshots of error rated, time spent, costs etc. etc.
I am sure this system will make a positive difference but it would be nice to know that the scale of impacts have been measured - not claimed in advance!
David.

7 comments:

Anonymous said...

With a 99.9% certainty I can reliably predict no baseline workflow measurements were undertaken to provide a benchmark against post system implementation benchmarks. It makes too much sense to do so.

Also it's perceived as being wasteful of resources, boring, and not sexy when all the excitiment and sense of urgency to have everything finished yesterday is where egos are focussed and the action is at.

No time to waste - we must save the world by moving forwards. Forget the evidence base it could be very embarrassing.

Anonymous said...

Yes Uniting Health Care are championing this project a fair bit - and it probably requires further scrutiny. It’s a relatively small hospital. The vendor is Cerner. (In a very small hospital – “good luck with that”).
The organisation and vendor have had a relationship going back to the late 1990s. Most recent noises about this project need to be put into the historic context – there have been various attempts to extend the rollout of Cerner from its original footprint at Wesley Hospital into other Uniting Health hospitals with very mixed results. This project also occurred within the wider Queensland Health procurement cycle. IE Uniting HealthCare was the local case study/reference site for procurement of Cerner into QH

Hence it was a stepping stone for the vendor into large $$$ in QH. So I guess they are keen to make a story from it. So of course expect the health organisation and vendor to talk it up.

But Richard Royle has spoken at industry events this year using language that is intriguing in what it reveals describing project to industry an integrated EMR implementation into the first fully digital hospital. What’s that saying it’s just another technology project - So perhaps it’s not as ground breaking project it is being made out to be.

Karen Dearne said...

Yes, it is a Cerner EMR project See http://www.app.com.au/about-app/news/first-digital-hospital-regional-australia-completed-st-stephens-hervey-bay

Uniting Health Care actually received $51.9 million from the Department of Health for its e-health initiative.

Since this is taxpayers money, we should all be expecting to see detailed reports of outcomes and learnings for broader community use.

Does anyone know if the St Stephen's system is connected with the PCEHR?

Anonymous said...

This article contains two sentences that I find potentially misleading.
The first:
“Errors could no longer be made by misinterpreting handwriting on prescriptions because all information was recorded digitally.”

And then:
“If a doctor tried to prescribe a drug that the patient was allergic to, an alarm would sound when it was scanned into the digital system, Mr Royle said.”

So, how are prescriptions actually written at St Stephen’s Hospital? Does a doctor write them using the Cerner system, as is inferred by the first sentence, or are they written by hand and then that prescription is scanned, as would appear from the second sentence.

If it is the former, then well done for getting doctors in a private hospital to use a computerized medication management system. If it is the latter, then how does the system digitize the doctor’s hand writing? I know that recognition software has come a long way, but as we all know, doctor’s handwriting is the earliest form of data encryption!!

Anonymous said...

I think by 'scanned' they don’t meant the prescription, but rather the medication itself has a bar code (e.g. on the bottle/pack) that when scanned using a barcode reader together with scanning a patient's wrist band barcode might provide a point to check for allergy/intolerance.
Of course one would hope that this integrated system could check for allergy also at the point of the doctor ordering the medication for the patient. Never hurts to check again though - just in case the allergy has been updated, or the medication lot has been recalled.

greg young said...
This comment has been removed by a blog administrator.
Dr David More MB PhD FACHI said...

I have to say I am not sure the arithmetic and some of the points actually make sense here!

Interested in other comments.

David.