We need the tools to collect all of the information in one place — a virtual clearinghouse where people can see and review all of the data that is being collected about them. Not only do they need to make sure that it is accurate, but also they could take the opportunity to get a glimpse into what others know about them, something amazing in its own right.
The question has been raised: Why re-invent the EMR wheel? What is so different about what I am doing that makes it necessary to go through such a painful venture? I ask myself this same question, actually. Here’s my answer to that question.
A big problem with changing the focus of healthcare in the United States is that hospital chief executive officers are incented to produce profits for their institutions. If you were a hospital CEO, why would you want to emphasize preventive care and outpatient services when your bonus is tied to profits, admissions, and growth?
In the years since that first difficult bedside admission, I have done my best to avoid making medical errors, but I still make them. I still find it very hard every time I meet with a patient and family members to acknowledge that I made a mistake.
If you are interested in patient safety and medical errors and haven't read the story in the Texas Observer about a spectacularly incompetent neurosurgeon, you should. It is long but worth it. As I tweeted last week, it will make you cringe. The story includes many details about operations done poorly and patients suffering paralysis and death at the hands of Dr. Christopher D. Duntsch.
I am by no means a hospital policy expert. But, it’s not hard to see that across the country, smaller hospitals are either being bought or joining larger hospital systems. This has already played out in Ohio’s larger cities of Cleveland, Toledo, and Columbus.
If all medical, nursing, and ancillary staff members are not aware of the tracking features of EMRs, they should be. This is the same type of tracking that catches unauthorized personnel who peek at the chart of a celebrity or other prominent patient in the hospital.
What should doctors disclose to patients in the aftermath of adverse events? Does it matter if the adverse event was related to an error? Does it matter if it was preventable or not, anticipated or unexpected? Recently, I was at the Carolina Refresher Course facilitating a session on adverse events in anesthesiology. We touched on a variety of issues, but spent the most time discussing the importance of disclosure conversations.
For years, Dr. Mark Katlic wanted a more specialized surgical approach for older people. Last fall, he persuaded executives at the nonprofit health organization LifeBridge in Baltimore to take that step. The Sinai Center for Geriatric Surgery, which he directs, is one of the first to focus on elderly surgical patients, and it is already collecting information on what improves their experiences in the operating room and afterward.
Just a little over four years ago, President Obama, in his inaugural address, challenged us a nation to “wield technology’s wonders to raise health care’s quality and lower its costs.” This was an awe-inspiring, “we will go to the moon” moment for the healthcare delivery system. But the next thought that ran through the minds of so many of us who work on health IT issues was this: how were we going to get there?
An orthopedic surgeon from New York reportedly has 261 malpractice suits against him. He has been accused of performing "phantom" and unnecessary operations. If you've been following my blog, you know that I am not a big fan of lawyers. But I have to admit that one lawyer's questions about what the hospital knew about all this and why the surgeon wasn't scrutinized sooner are good ones.
I suppose that most of my surgical heroes if they were in the current system would be referred to various well-being committees. They would have to undergo gender and cultural counseling. Many might have even been suspended or had their privileges amended. But they had all passed their boards and they could all do their job.
We’ve run amok with wearing gloves in the hospital. And by “we” I mean every healthcare worker in sight. I see people putting on gloves before they’ll give a patient a clean warm blanket. This is not only ridiculous, it’s actually harmful. Here’s why.
Going through the skin, the initial cut — that’s the cataclysm, the breaking of the barrier, the crossing of the line. It’s the leap of her faith, the breaching of the wall, the stepping into space. Within moments, it’s routine, nearly generic: his insides look like mine, yours. Been there. But the primal cut, the slice through that first and last line of protection, his skin, her freckles, the fine little hairs, the vulnerable innocence.
Every so often I have an extraordinary and surprising experience with a patient—the kind that makes us both say, "Wow, we've learned something from this." One such moment occurred recently. When one gentleman arrived at the hospital for surgery, the admitting clerk asked him to pay roughly $20,000 upfront to cover the estimated balance of a simple outpatient surgical procedure.