Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
http://www.news.com.au/story/0,23599,22404849-2,00.html
Bar codes for patients to stop medical bungles
September 12, 2007 07:37am
Article from: The Courier Mail
- Patients to be stamped with barcodes
- 31 wrong operations performed last year
- Patient misidentification main problem
HOSPITAL patients in Queensland are to be stamped with bar codes in a move to prevent operations being performed on the wrong body parts.
Last financial year 31 mistaken procedures were performed, including three cases of the wrong tooth extracted and two operations on the incorrect part of patients' spines.
In another instance, a person's left tonsil was removed in error and a separate patient had botox injected into the wrong body part.
Queensland Health's Patient Safety Centre senior director John Wakefield presented the figures to a Royal Australasian College of Surgeons state meeting near Cairns.
…..( see the URL above for full article)
This is very good to see. I must say I have always been a bar coding enthusiast in the right circumstances and in the right application. It is a cheap and effective technology that make a major contribution is all sorts of situations.
Second we have:
http://www.boston.com/yourlife/health/other/articles/2007/09/10/eyes_shift_from_patient_to_keyboard/
Eyes shift from patient to keyboard
By Dr. Michael Hochman | September 10, 2007
When I began my residency last year at the Cambridge Health Alliance, I was thrilled to discover that I would be using a computerized medical record system. Computerized medical records - which are now used by about half of Massachusetts physicians and a growing number of doctors nationwide - are truly revolutionizing medicine, allowing doctors to chart patient information more safely, effectively, and legibly than ever.
Although the computerized system has proven to be a huge help, I have confronted an unexpected challenge: Despite repositioning the computer in every imaginable way, I often find myself making more eye contact with the screen than I do with my patients. It is simply more difficult to face a patient while typing than while writing.
When I ask my patients whether the presence of the computer bothers them, most are understanding (though one pugnacious older lady told me that my face looks better from the side anyway).
…..( see the URL above for full article)
This is a useful article to remind people that it is important to consider the patient when using a computer to record clinical details. It is all too easy to slip into a total focus on the computer and leave the patient ‘up in the air’.
The solutions suggested in the full article are all worth careful consideration.
Third we have:
Microsoft: Better software can prevent medical mishaps
By Ina Fried
http://news.com.com/Microsoft+Better+software+can+prevent+medical+mishaps/2100-1012_3-6206849.html
Story last modified Mon Sep 10 12:49:40 PDT 2007
Inside a business, software with a good user interface can improve productivity. Inside a hospital, it can save lives.
That's the premise behind a new collaboration between Microsoft and Britain's National Health System that seeks to develop a common design for clinical software. Microsoft isn't trying to prescribe the entire software design, but is proposing some commonality in terms of where on a screen medications are listed and what types of information about the drug are listed.
"It is kind of like when you get into a car," said Tim Smokoff, general manager of Microsoft's health care unit. "Every dashboard looks different, but they are all kind of the same."
By standardizing on a common way to display medical data, Microsoft hopes the industry can make a dent in the 600,000 errors that take place in U.S. hospitals each year, many of them from medication mix-ups.
…..( see the URL above for full article)
This is interesting as it shows the UK NPfIT and Microsoft are working to optimise the quality and safety of the user interface systems in use in the UK National Health Service. It will be fascinating to watch, as the NPfIT implementation progresses, to see any quality evaluations of the effect of an improved user-interface on overall system operation and clinical outcomes.
Fourth we have:
http://govhealthit.com/article103607-09-10-07-Print
On the bleeding edge
Busy emergency rooms are vital sources of leadership and ideas for the health information exchange movement
If you’re looking for doctors who are enthusiastic about health information technology, you often need look no further than hospital emergency rooms.
Physicians who specialize in emergency medicine are disproportionately represented in the ranks of local and national health IT leaders. Examples include:
- Dr. Brian Keaton, president of the American College of Emergency Physicians and an emergency medicine physician in Akron, Ohio, leads the Northeast Ohio Regional Health Information Organization (RHIO).
- Dr. Edward Barthell, executive vice president of strategy and clinical affairs at Infinity HealthCare in Wisconsin and a practicing emergency medicine physician, is a founder of the Wisconsin Health Information Exchange (HIE).
- Dr. John Halamka, an emergency medicine physician at Beth Israel Deaconess Medical Center in Boston, is chief information officer at Harvard Medical School and chairman of the Healthcare IT Standards Panel chartered by the federal government.
- Dr. Craig Feied and Dr. Mark Smith, emergency medicine physicians at Washington Hospital Center, were among the creators of the Azyxxi software that Microsoft acquired for its foray into health IT.
In addition to such physicians’ prominence among health IT leaders, emergency departments are often the starting point for RHIOs and other projects that involve sharing all or part of patients’ records.
....( see the URL above for full article)
This is a useful extended article that is worth a browse outlining the place of ER computing in the overall Health IT initiaitive.
Lastly we have:
http://www.e-health-insider.com/news/3019/wanless_warns_npfit_risking_nhs_modernisation
Wanless warns NPfIT risking NHS modernisation
11 Sep 2007
In a review of NHS modernisation efforts Sir Derek Wanless has criticised the slow progress of the National Programme for IT (NPfIT) and called for an audit of the programme to ensure it supports wider health service modernisation.
The report warns that considerable challenges lie ahead in modernising NHS IT systems and says there is "continuing debate over the feasibility of some current NPfIT plans".
With limited progress on its core objectives, and the lack of a clear measurable business case against which savings can be measured it says that Connecting for Health, the agency responsible for NPfIT, appears to be being allowed to follow "a high-cost, high-risk strategy that cannot be supported by a business case". Concerns are also expressed about the future impact of the monopolistic contracts awarded by the agency.
The report analyses the progress of NPfIT within the wider context of NHS modernisation and investments made and finds the programme wanting in key areas, particularly enabling productivity gains within the service. It observes that NPfIT has largely occurred in the absence of any published or measurable business case.
Despite receiving very significant investment since 2002 Wanless says the programme has so far largely failed to deliver. "The extent to which the NHS will benefit from these investments remains unclear."
In the King's Fund commissioned report Sir Derek provides a progress report on the government's progress on NHS modernisation. In 2002 he carried out a strategic review of the health service, for the then chancellor Gordon Brown, which was instrumental in making the case for a 50% increase in NHS spending.
The 2002 review identified better use of information and communication technology (ICT) as key to potential productivity and health gains. In his progress report Sir Derek says these productivity improvements have not been achieved.
....( see the URL above for full article)
The report is found here : King's Fund: Our Future Health Secured? (PDF)
This article and the associated report is a reminder – if one is needed – that Health IT should be serving the needs of the health system. The IT can’t and must not be an end in itself.
All in all an interesting start to the week!
More next week.
David.
1 comment:
Bar codes will help more efficiently identify individuals and make it quicker to enter information into the computer.
However, errors will still occur. Bar codes won’t stop them. It’s the humans that make the errors. If the humans don’t cross check thoroughly, or if the humans put the wrong bar code on the wrong person - who will know?
And another thing - at least today I can read the label round my wrist and almost read the label round my ankle (and if I can’t my wife can). That’s why we noticed the label round my wrist differed from the one round my ankle and we got the problem rectified before my operation got underway.
I think bar codes are very useful but we can't read them - so errors can still occur. Perhaps we have to train people to be more careful - or is that too much to ask?
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