Sunday, March 29, 2009

One step could dramatically improve hospital care and patient safety

Information has many ways of falling through the cracks in hospitals and medical practices.

The wrong test may be mistakenly ordered by the doctor. The ward secretary may order the wrong test. The lab may perform the wrong test, or rarely perform it on the wrong person. The result may not be available until after the patient leaves the hospital, and then gets lost in cyberspace; or it reaches the chart after the doctor has dictated the discharge summary and is never seen.

Usually more than one doctor takes care of each patient, but each may not be aware of everything the other has done, or which tests were ordered and are still pending.

A simple fix would be to require that all electronic medical records systems must be linked to the laboratory and radiology departments, and must be able to generate a list of all tests ordered; their results; and those tests whose results are still pending. At the end of a hospitalization, each doctor would have to sign off on the list, to ensure all tests had been considered.

We currently have a hodge-podge of hundreds of proprietary EMR systems that do not communicate with each other throughout the US, and the system I use does not have this capability.

Electronic medical records are a wonderful idea in theory. In practice, they are fraught with difficulties and potentially may be accessed or "hacked" by unauthorized individuals, making a mockery of patient confidentiality. The problem of confidentiality is central to getting a working EMR system in place throughout the nation, through which doctors and patients can communicate; yet it requires cybersecurity resources beyond the financial resources of hospitals and medical practices in the private sector. This is why the development and maintenance of such a system must be federalized.

1 comment:

Anonymous said...

With all due respect, How much of your life do you want to turn over to the feds? Is there nothing sacred? Give the feds your health info and they can then gain control of your life. It sounds like the next step is to get an implanted chip that will record our bank info, medical info, and everything else. Then, we can go to the gas pump and wave our arm to get gas. Then we can wave our arm at the ER check in and avoid filling out a form. And maybe we can also receive that ol' mark of the beast while we are at it so that no one with out that chip will be able to buy or sell. Thumbs down to your suggestion of federalizing our health care info! Also, what about sun spots? Do we really want everything limited by electronics? In the likely event that sun spots hamper our electronics, we would be at a loss of how to function once reliant upon this "wonderful idea" of electronic medical records.

Mom in Moore Haven