Simply acquiring technology is not enough; it is essential to implement the technology effectively to achieve those types of results. Here, then, are the top 10 mistakes practices make in implementing information technology — and how to avoid making them.
I was not aware how common these errors are until I became a patient myself after being diagnosed with hypopharyngeal carcinoma. I am sharing my personal experiences about the medical and surgical errors that occurred during my hospitalizations at three different hospitals. My inability to speak after surgery made it difficult for me to prevent all of these mistakes. Fortunately, I was able to abort many of them.
While it may seem that the financial problem created by expensive, proprietary health IT is simple and straightforward—health IT expenses push the budget into the red, doctors see fewer patients, revenue falls, and creditors come calling—healthcare economics are unique and apparently beamed from some other dimension where up is down and black is white, so linear explanations don’t really hold.
I hope that the FDA’s efforts investigate robotic surgery will not slow or dissuade brilliant individuals and forward-thinking companies from developing more useful solutions for the operating room. I have no desire to see hospitals, surgeons, and OR staff members balk at these solutions in favor of re-embracing traditional or old-fashioned practices and attitudes.
“Innovation in medicine is driven by need, but also by the market,” said Dr. Michael R. Harrison, the director emeritus of the Fetal Treatment Center and the director of the Pediatric Device Consortium, both at the University of California, San Francisco. “Big markets have lots of folks developing devices, but small markets like the pediatrics market don’t.”
One obvious question: is the robot another “laser”? There is a more fundamental and important question. Granting that the pace of traditional development and evaluation of products may not excite investors, are we going to cede that vital function to those for whom scientific probity may not match their interest in the equity market?
Most clinical providers are aware of the more common capacities of EHRs. However, there are many capacities that are being underused that can be of great assistance in providing safe care that avoids waste and identifies best practices. Electronic communication with providers outside of one’s clinical setting, clinical decision support, and improving the body of knowledge of best practices are three capacities of modern EHRs.
It is almost 7:00 a.m. and I carry my briefcase and lunch bag from the car to my office. I nod to some of the night shift employees heading home. Another day has begun. I type my password and check the computer, reminding myself of the twenty patients I am scheduled to see today in the cancer clinic. A few new consults with untreated or recurrent cancers occupy the longer appointment slots.
No recent internet headline or cleverly-worded web teaser caused me to click my computer mouse on it faster than one that linked to a video discussing a Consumer Reports study on hospital safety. Strangely enough, it wasn’t the subject matter that grabbed my attention. It was the tone of the headline: “Hospitals Get Low Safety Scores In New Study.”
Am I safe surgeon, or merely a board certified one? I usually spend Tuesdays fixing elective hernias. But the other day I was asked to clear a c-spine, handle an unexpected gynecologic finding, manage a pediatric trauma, resuscitate a septic ICU patient, and opine on a neck dissection. No, I wasn’t in Africa or 1985; I was sitting in front of a computer monitor.
Medical schools have traditionally relied on undergraduate science grades and the MCAT to decide which applicants to interview. They based this approach in part on numerous studies that found good correlations between science G.P.A. and MCAT scores and subsequent medical school performance. But more recent studies have also revealed that MCAT scores are significantly influenced by a student’s race, gender, and socioeconomic background.
While there are some ways in which robots can replace human involvement during surgery, it’s unlikely that robots will completely replace human surgeons. This is because human intuition, reasoning, and experience will continue to be invaluable. Robots offer doctors and surgeons a more advanced form of decision support, make them faster, and even allow them to work remotely.
Robotic technologies combined with improved sensors and sophisticated intelligence will make inroads into many aspects of medical care, including surgical centers and operating rooms. With a proven ability to automate actions with outstanding repeatability and reliability, the opportunity exists for robots to move into non-critical and routine medical procedures.
Will a universal EMR save dollars? Not right away, but in the near future, absolutely. Will it improve the safety, quality and efficiency of medical care and thereby save lives. Definitely. Is there any reason to maintain our system of primitive individual medical isolation? None at all, continued delay would be ridiculous.
A recent American College of Surgeons Bulletin article states that surgeons and liability attorneys want similar things for patients. "Both surgeons and patient attorneys are committed to patient well-being and the relief of patient suffering." Really? So for liability attorneys, it's not about the money? I see; it's about "relief of patient suffering."