Friday, January 03, 2020

That There Are Errors In Care Related To EHR Use Is Not A Surprise. There Are Also Errors When They Are Not Used!

This appeared last week:

Health documents reveal patient harm linked to Queensland's new medical record system

Exclusive by state political reporter Josh Bavas
24 December, 2019
Almost 100 cases of patient harm have been linked to Queensland's new electronic medical record system in just over a year, including instances of patients being administered incorrect doses of drugs.

Key points:

  • Documented cases include child given 10 times the amount of insulin they were prescribed and a patient administered morphine in milligrams, not micrograms
  • One patient in severe pain was unable to be given pain relief because of a 'computer system failure'
  • Queensland Health says the Integrated Electronic Medical Record (ieMR) is working well
On one occasion late last year, a child at Queensland Children's Hospital was mistakenly given 10 times the amount of long-acting insulin they were prescribed.

In other examples, a child at the same hospital was given incorrect morphine over the course of a day, an adult at the Mackay Hospital was mistakenly given more than double the required units of insulin and another patient at the Sunshine Coast was administered morphine in milligrams instead of micrograms.
These are just some of the 95 cases of harm linked to the new Integrated Electronic Medical Record (ieMR) system recorded by Queensland Health from January 2018 to April 2019 and obtained by ABC News after a Right to Information request.
Another incident at the Ipswich Hospital in January recorded a patient in severe pain who was unable to be given pain relief because of a "computer system failure".
Health documents state nursing staff were unwilling to administer any medication simply because the "computer system was down".
In another case, a patient was administered drugs due for another person.
The ieMR network replaces various paper-based clinical charts with one online platform and has been deployed across 16 hospitals with a further 14 to come online soon.
While the ieMR was documented to be a contributing factor in each case, Queensland Health said 45 instances were due to user error and 32 because the system was found to be "difficult to use".
Other contributing factors included poor communication, lack of training, missing documentation and inattention.
In March, the ABC revealed the Australian Medical Association secretly called on the State Government to halt the ieMR rollout over concerns about patient safety.
Lots more here:
The problem with such claims is the counter factual which we don’t have regarding error levels before the iEMR was implemented and we don’t know what errors have been eliminated and which accentuated.
Remember the iEMR makes it much easier to track errors of many types.
A decent before and after study and careful staff training are needed to know if the effect is negative or positive.
David.

2 comments:

  1. Dr Ian ColcloughJanuary 03, 2020 6:26 PM

    A big Bang, fast-tracked, State-wide roll-out, is a vendor's delight; achieving maximum customer coverage and exposure, accelerated revenues and widespread irreversible customer lock-in, before system deficiencies, project creep and functionality problems, all ;begin to emerge necessitating major contract renegotiation and revision of budget, scope and project timelines. once again - a vendor's delight.

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  2. A decent before and after study and careful staff training are needed to know if the effect is negative or positive AND here is another stumbling block...the scarcity of before and after studying 'by suitably qualified personnel' let along the ongoing management of the quality of documentation and functionality by the departments meant to be tasked with same.

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