There have been two different bits of news last week.
First we had this.
Near half-billion-dollar South Australian hospital records system failing: AMA
The AMA has said a new electronic records system being rolled out in South Australian hospitals is not fit for purpose.
A new electronic records system being rolled out across South Australia's public hospitals is possibly not fit for purpose, according to the Australian Medical Association (AMA).
The AMA said it sent a questionnaire to almost 250 staff members, including doctors and nurses, asking for their views on the AU$422 million enterprise patient administration system (EPAS).
It says almost 40 percent reported that their opinion of EPAS was poor, 30 percent believed patients are not clinically safer, and 20 percent found it responsible for adverse patient outcomes.
"The AMA has consistently supported the concept of electronic medical records," president William Tam said on Wednesday.
"Yet our members are telling us that EPAS has failed to meet their hopes and expectations and is contributing to errors.
"You might expect some teething problems, but quite honestly, after four years we would expect most problems to be fixed."
However, Health Minister Jack Snelling said the government believes those who responded to the AMA survey were not representative of the wider medical workforce.
Snelling told state parliament that the AMA is a "serial whinger".
Lots more here:
Secondly a Coroner’s Enquiry that involved the ePAS System reported last week:
Death of ex-Socceroo Stephen Herczeg, 72, at Queen Elizabeth Hospital preventable, coroner rules
Andrew Hough, The Advertiser
August 9, 2017 6:53pm
A FORMER Socceroo’s “horrific” and “macabre” death at a major Adelaide hospital was entirely preventable, the State Coroner has ruled.
South Australia’s first World Cup qualifying player Stephen Herczeg, 72, died in extreme pain at the Queen Elizabeth Hospital from respiratory failure caused by a ruptured bladder and collapsed lungs on September 19 last year.
An urgent inquest was told his bladder ruptured and his lungs collapsed after oxygen was mistakenly attached to a catheter tube meant to drain urine.
In his findings handed down on Thursday, State Coroner Mark Johns ruled Mr Herczeg’s death was “entirely preventable” and said the level of observation on him in the hours before his death was “inadequate”.
There is a great deal more here:
Of most interest were the recommendations:
Here they are:
"Mr Johns made five recommendations to Health Minister Jack Snelling:
THAT EPAS modifications for CO2 retaining chronic obstructive pulmonary disease patients have both upper and lower limits on oxygen saturation levels;
THAT a password be entered into EPAS when observations are recorded;
THAT the practice of one person taking observations and another person entering data onto the EPAS system cease;
THAT if respiratory patients are not admitted to a respiratory ward, the admitting doctor provides detailed instructions to staff leaving no room for error;
THAT patients exhibiting confusion undergo a risk assessment prior to their admission to the ward."
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Clearly there is a need for a little re-training and behavior modification for staff using this system.
This is the first time I can recall when an EHR system has been found, in a Court, to not have been implemented to a standard that was maximally safe and useful!
David.
there is a need for a little re-training and behavior modification for staff using this system
ReplyDeleteUnfortunately David, that is the same mistake that the system designers (if you can call them systems designers, not apps developers) make. If the users have to be trained and to adapt to the system, it is already a failure.
It's been said before, health care is a social art therefore a good system allows users to work in the way that best suits them, but also permits them to modify their behaviour and work smarter.
Information systems in health care should support people, not force them to work according to some badly thought through IT system.
I don't agree - for the best and safest results you need to apply discipline and common sense to use of the system, that has been properly implemented. That seems to have been missing!
ReplyDeleteAre you referring to health care "discipline and common sense" or IT "discipline and common sense"
ReplyDeleteOrganisational!! Train and plan implementation properly...
ReplyDeleteBernard said "Information systems in health care should support people, not force them to work according to some badly thought through IT system."
ReplyDeleteAll to often we see health IT systems developed and forced upon the end user with too little thought given to improving the business processes of the organisation. We do know that existing manual processes and procedures in the complex hospital environment have been developed, topsy-turvy, on top of what went before.
Introducing a new IT environment offers unique opportunity to make substantial improvements in the overall system. That opportunity is often lost as the vendor endeavours to thrust its 'vanilla' system into place, which inevitably results in user push-back as deficiencies in the system design come to light and the vendor pays a modicum of lip-servie to 'fixing' the problem.