Posts Tagged ‘medical technology’

Week in Review (April 18 – 22, 2011) The Eye Opener Health and Law Blog

Saturday, April 23rd, 2011

From the Editor:

This past week, our blawgers (guess I’ll use this term now since we are legal bloggers) were busy on their keyboards once again. They covered a number of topics relating to law, medicine, health and patient safety. This week we posted a primer on aortic aneurysms and how they can present as back pain, a blog about “robot” anesthesiology, a disturbing post about how the recent threat of a federal government shutdown was averted but at a cost to those who are in dire need of healthcare, an interesting piece about laughing gas making its way back into the American medical scene for labor and delivery and finally, and a highly read piece on a not-to-often discussed topic but one of potential grave concern – shift switching by nurses and how this might impact patient safety.

Here’s our usual “quick summaries” for you to peruse, click on, read and comment:

Aneurysms – a deadly condition you need to know about!

Our in-house medical specialist, Theresa Neumann, wrote another highly educational and need-to-know piece about a condition that can present as back pain but which has deadly consequences for those who have this condition.

As Theresa’s research made us aware – “1 in every 50 males over the age of 55 have an abdominal aneurysm, this is a more common pathologic diagnosis than some others.  Men also corner the market at an 8-to-1 ratio as compared to women with abdominal aneurysms.”

As is the case with all of Theresa’s writings, we offer through her valuable information from someone who’s “been there” and “done that” in the clinical setting. Don’t miss her post entitled Aneurysms: A Potential Deadly Condition That May Present as Back Pain.

Who’s using remote control and a joy stick to put a breathing tube down your throat?

Mike Sanders brought to our attention a new practice of anesthesiologists – in Canada – that may soon be part of anesthesia management in the United States as well – using robotics to intubate patients. While you can certainly learn about the concept of intubation by reading Mike’s blog, basically, this is placing a small tube down a patient’s airway so that the anesthesiologist can control the airway and provide ventilation to a patient undergoing surgery.

Here’s an except -

Medical News Today is reporting that Dr. Thomas Hemmerling of McGill University and his team have developed a robotic system for intubation that can be operated via remote control.

For more on this fascinating new project by Dr. Hammerling and his team, read Mike’s post entitled Robot Anesthesiologists?

Government Shutdown Avoided – but who will pay the price for the “deals” that were cut?

The newest member of our blogging team, Jason Penn (fast approaching veteran blawger status) did a fascinating piece of the story-behind-the-story of the recent crisis our country faced when the federal government was on the verge of a shutdown. We all know about deals being cut in the back rooms of congress. We all know that the government avoided a shutdown this time around when the senate and house worked out a compromise that resulted in millions of dollars being earmarked for cuts in the budget.

Jason tells us what programs relating to healthcare will suffer as a result of these negotiated cuts. As some wise person once said, “why is it always those who are least represented who bear the burden of budget cuts?” Maybe it’s because they can’t afford lobbyists to protect them like those who need protection the least can.

Read Jason’s eye opening and no-punches-pulled report on just who will be the victims of the deals in his post of this past week Budget Crisis Avoided, But What About the Babies? Can They Live With $504 Million Less in Funding?

Will moms-to-be now be “laughing” their way through labor and delivery?

One of our seasoned blawgers, who every now and then is driven to report on the off-beat issues of law, medicine and healthcare, Jon Stefanuca, stepped up to the plate once again and took a swing at the return of an old-timer to the arsenal of pain relief for mothers-to-be undergoing labor and delivery – laughing gas!

As Jon’s piece in Eye Opener this past week tells us -

It appears that a number of hospitals are now considering making laughing gas available as a pain relief measure for women in labor. A hospital in San Francisco and another in Seattle have been using laughing gas in their labor and delivery units for a while. Hospitals like Dartmouth-Hitchcock Medical Center plan to offer laughing gas to laboring mothers in the immediate future.

For more about this return of laughing gas to our obstetrical units, read Jon’s piece Laughing Gas Making Its Way Back Into the Labor and Delivery Department.

Nursing and Sleep Deprivation: Is it a risk factor for patient safety?

I suspect somewhere along the line you have done “an all-nighter” – whether it was getting ready for a big test, a social event, or for some other reason. Remember how you felt as you made it through that night or the next day? Have you ever done it several nights in the same week? How about doing it a few times one week and then do the same thing the next week and the next…. Well you no doubt get the idea. You’ve been exhausted, right? Well what about nurses, who have to do this for a living?

Nurses have lives too. They have children, home responsibilities and obligations, and some form of social life. What happens when they swap shifts or are asked to do “a double”?

Sarah Keogh was back blogging this past week and wrote a fascinating (and concerning) post entitled Nurses Switching Shifts: Does a Lack of Sleep Put Patients at Risk? We invite you to read Sarah’s piece and share your comments. Are you a nurse who lives this lifestyle? What are your thoughts about nurses being allowed to work multiple shifts or back-to-back shifts in terms of patient safety? Should there be restrictions on nurses’ shifts just as there (finally) are work restrictions on doctors-in-training?

A “Sneak Peak” of the week ahead

As part of our continuing effort to “get the word out there” on issues relating to health, medicine, patient safety and the law, we post from time to time more extensive research pieces called White Papers. Well, the time has arrived for another White Paper to be posted on our website. Marian Hogan has completed her piece on a very important topic – Patient Controlled Analgesia in today’s hospital environment. She examines how some hospitals are now heavily marketing a spa-like environment so you choose them over the competition. Yet lurking in the shadows of these facilities which promote flat screen TV’s, valet parking, in-room safes and the like is a very dangerous practice: placing patients on patient-controlled-analgesia (for pain relief) without vital monitoring devices and patient safety practices. It’s at the “printer” now; we hope to have it online this week.

From our blawgers you can expect reports on a disturbing fight between manufacturers and child safety experts over – blinds! After decades of controversy, you’ll find out where the battle lines are now drawn, who’s winning and who the real losers are in this war. Wonder how healthcare safety is doing since the report To Err is Human was published by the Institute of Medicine over a decade ago? Jason Penn will be providing an updated report card, which you should not miss. Alcohol and surgery – not a good combination! Jon Stefanuca plans on posting a piece that looks deeper in the obvious problems with this potentially deadly combination.

This is just a taste of what’s to come. I better wrap-up now. I’m working on finishing the third installment on Medical Technology and Patient Safety. Oh yeah, if time permits, I might even get to post a piece I’ve been working on this past week – a lawyer’s rant about our modern day love affair with mediation practices and trends.

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Hope you have a great weekend!

Week in Review: If you missed this past week’s blogs – catch up!

Sunday, April 10th, 2011

This past week was a busy one for our bloggers. It was also a very busy week in our law practice. Over the last two months, we have also had two new lawyers join us – Sarah Keogh and Jason Penn. Sarah has contributed a number of posts already. Jason , who just started this past Monday, will soon be sharing his contributions, thoughts and comments with you as well. We’re very happy to have both of them. I’m sure you join us in wishing them a very warm welcome.

Last week our writers covered a number of topics related to health, medicine, child safety, medical technology and patient safety. We started the week off with a piece by Brian Nash on some key facts women need to be aware of when having an epidural for labor, delivery and post-partum pain relief.

Epidurals

There can be no doubt that thousands of epidurals are administered to women every day throughout this country. This form of analgesia (pain relief) has become probably the most popular form of anesthetic management and apparently is generally believed to be essentially risk free. As this week’s piece, Having an epidural when you have your baby? 3 questions to ask the doctor, reports, some literature gives the figure of complications from epidurals as high as 23% - ranging in severity from minor inconveniences, to life-long major disabilities and even death.

This particular piece was written as a result of several cases in which we have been involved when women, who had undergone an epidural, became essentially paralyzed from the waist down. We raise some questions for women to ask the doctor and suggest they just might want to ask those questions before they find themselves in the process of labor or when they are going through the recovery phase of having given birth to their baby. We believe it’s an important piece for women – and frankly for all – to read so that they have a much better idea of what they should expect with an epidural and what the risks and benefits are of this wonderful yet potentially life-altering anesthetic technique.

Shaken-Baby-Syndrome

On Wednesday, Jon Stefanuca again brought to the public’s attention a problem that is probably as old as childbirth. Everyone who has had the experience of taking care of a child – particularly a baby – knows that along with the joy of parenting comes the physical and emotional toll on parents and care-givers. The human condition makes us all susceptible to being less than completely tolerant, forgiving and gentle with little ones when we are under stress, frustrated or just plain exhausted. The response to the persistent crying can simply not be “a good shake.”

Medicine and science (and unfortunately the courtroom) have given a name to a syndrome of injury babies can suffer when that “just a good shake” approach is used. While a parent or care-giver may think it unimaginable to strike a child, they may not realize just now much harm they can do with “just a good shake.” Jon brings this information and some expert tips and tricks on how to deal with these difficult times parents and care-givers face in their everyday lives in his piece Shaken Baby Syndrome – What we all should know to prevent child abuse.

Makena: New Anti-Prematurity Drug

Thursday, Sarah Keogh reported on a relatively new drug called Makena, which has been found to help pregnant women, who have previously had a premature infant. I say “relatively” since according to Sarah’s piece, a compounding pharmacy could and was making this medication prior to the FDA giving K-V Pharmaceutical Company the exclusive rights to manufacture this drug for a period of 7 years.

Read Sarah’s piece, Makena: Drug to fight prematurity leads to major firestorm, and see what the controversy is all about. How could people possible be upset with a drug that can fight premature birth? Prematurity is one of the major causes of significant childbirth injuries such as cerebral palsy. Sarah’s blog makes it all too clear why people are upset and why the March of Dimes withdrew its sponsorship for Makena.

Medical Technology and Patient Safety

The week ended with Part II of my series on medical technology and whether all the new toys, bells and whistles of our modern healthcare system are truly advancing safe, efficient and effective delivery of healthcare. The week’s piece focuses on perhaps one of the largest advances in the healthcare industry – electronic medical records (EMR).

The blog, Medical Technology and Patient Safety – Part II – EMR’s (electronic medical records), brings a lawyer’s perspective to this topic. Much has already been written – and frankly will continue to be written – about EMR’s by the medical profession. Controversy has filed the pages of journals and at times probably slowed traffic on the internet (okay – maybe that’s a bit of an exaggeration) since this new marvelous technological advance was rolled-out in our medical institutions.  Those writing and fighting about it have been the end-users themselves – the medical professionals, who have to deal with the issues and flaws that have surfaced with this wonderful new technology. I thought it was about time to tell you how this plays out by another end-user – the lawyer who now deals with EMR’s. This piece is also intended as the foundation for what we as lawyer have seen play-out in terms of patient safety and health as a result of EMR implementation.

Sneak Peak of the Week Ahead

I anticipate that next week we’ll be seeing Jason Penn with his first blog on a recent report about numerous safety violations by hospitals in our practice jurisdictions – Maryland and Washington, D.C. Mike Sanders will be bringing to our readers aN old but back-in-the-news report on super infections, which still seem to be – unfortunately – thriving in our nation’s hospitals. We’ll start off this coming week with a piece by Theresa Neumann, our highly acclaimed in-house physician’s assistant expert, on spinal stroke. We all know about strokes that can damage the brain. Theresa will be sharing her insights on an equally devastating stroke of the spinal cord. I also suspect – shhh – that we’ll be reading more from Sarah Keogh this coming week. If the practice of law doesn’t get too much in the way, I am also hoping to share with you some real life examples – from a lawyer’s perspective – of just how EMR’s may not be advancing the causes of patient safety and health.

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Medical Technology and Patient Safety – Part II – EMR’s (electronic medical records)

Saturday, April 9th, 2011

Let’s begin the discussion about whether or not medical technology is truly advancing the efficient and safe delivery of patient care with the topic of electronic medical records (EMR’s). Much has already been written on this subject; however, a recap of some of the arguments being made – pro and con – for EMR’s will set the stage for what I believe is the major problem with this technological advance.

If you have ever had to review old-fashioned hand-written records relating to a patient’s care, which I’ve been doing now for almost four decades, you were thrilled – at least initially - when you heard about the advent of this new, eye-strain-saving project. Not only was I counting on cutting down the number of times I would have to increase the strength of my prescription eyeglasses, I figured I might now be able to actually read what the healthcare provider learned by history, found on examination, thought was the more likely diagnoses causing the patient’s presenting complaint and what the doctor’s plans were to address the medical problem confronting that healthcare provider. What a bonus! No more guessing! Too good to be true?

Now with EMR’s, when you request medical records from a healthcare provider, you could expect to receive – presumably with the push of a “print” button, not papyrus-like records filled with hieroglyphics, but a formatted, easily readable comprehensive rendition of what happened in the course of patient care. Well, not so fast, I quickly learned.

With the arrival of EMR’s, I became mired in a world of radio buttons, drop down menus, cryptic narratives that didn’t really match the fill-in-the-blanks charting, and a world of metadata to find out the story-behind-the-story (like who accessed the EMR, what they were looking at and when they saw it).

Now let’s be real – I sincerely doubt that the medical profession and the computer and software vendors had lawyers in mind when they created and rolled-out this new marvel. As the medical profession is so quick to point out to us lawyers, lawyers are not the ones in the trenches trying to make people better and save lives. We’re the bottom feeders (oh yeah – that’s their description so many times), who do nothing but second guess for our personal monetary gain the medical community’s valiant efforts. That discussion is for another day!

Turns out, however, that it is not only my kind screaming about how this modern medical technology has flaw upon flaw associated with it; the medical profession has serious, second thoughts about just how wonderful EMR’s are.

The Concepts Behind EMR’s

Just do a search in your favorite search engine on the topic of EMR’s – add the word “controversy” or get really ingenious and pose the question: “What are the pro’s and con’s of EMR’s?” While you’re combing through page after page of search results, take note of who is writing about why EMR’s are not the next best thing to sliced bread. I’ll save you the task; it’s the medical profession. That’s right, the very people who hailed the advent of EMR’s and extolled the many intended virtues of this technology.

The Pro’s of EMR’s:

Here are some of intended benefits of EMR’s:

  • improve the quality of patient healthcare through instant, universal access to patient data (at the click of a mouse or push of a button)
  • avoid, if not eradicate, the “unreadability” (interpretation: I can’t read your handwriting; what are you telling me?) of hand-written chart entries.
  • improve patient safety through better detection of adverse events. The intended goal is premised on EMR’s having a central database of patient information, decision-making, outcomes (including adverse events) and other key epidemiological data available and accessible for analysis.
  • enhanced quality of care through immediate access of all pertinent patient information (e.g. testing, radiological studies, medications, vital signs, laboratory studies, etc.) so that caregivers can make better, faster and more informed decisions about continuing plans of care.
  • making healthcare more cost efficient by reducing unnecessary redundancy of testing (due to inability to locate prior paper-based information), digital access to key points of patient data rather than the waste incurred through manual search of past records from various healthcare provider sources, copying, faxing, etc.
  • keeping records safe: with proper digital storage measures, there can be avoidance of destruction, misplacement and the like.
  • overcoming inaccurate past medical history (PMH) information since care providers would have access to a patient’s “true and accurate” medical history by accessing stored medical data. Healthcare providers would no longer be relying on ofttimes faulty patient memory of PMH.
  • improved coordination and information exchange between healthcare providers. Studies have shown that the communication and transfer of information between primary care physicians and hospital-based physicians has been less than optimal.
  • improved, accessible and faster surveillance capabilities for wide scale events such as epidemics, catastrophic natural disasters (e.g. Katrina) and even bioterrorism.

I have absolutely no doubt that there are a host of other EMR pro’s. Yet even though the concept of EMR’s has apparently been the topic of discussion for about forty years and there are so many potential benefits inherent in their use, one must wonder – why did it take so long to implement EMR’s and why are they not being fervently embraced throughout the medical profession?

Some Con’s

As with many great modern marvels, once the allure of the new toy wears-off and implementation begins, some of the flaws begin to surface. ERM’s clearly have their share of warts.

  • privacy concerns – do EMR’s have the ability to turn the sacrosanct confidential communications between physician and patient on their ear? Some scream a resounding “yes.” Some have expressed deep-seated concerns that such accessible data will be used against a patient when they apply for jobs, health insurance, or – I’ve seen said – even a college scholarship. The potential inclusion of genetic data in EMR’s and the accessibility by researchers or others who don’t fit the need-to-know category also has privacy advocates screaming “foul.”
  • loss of the benefit of provider narratives (which were the norm in hand-written charts) so as to better appreciate the subtleties and thought processes of medical care. It is often said that medicine is an art, not a science. The ability to appreciate the art of medicine, some fear, has been lost when all that you can glean is pre-formatted information from drop-down menus and radio buttons. There’s no longer an ability to appreciate the true thinking process of the caregiver. Some refer to these problems as blind and meaningless use of short-cuts, templates and pre-fills, which don’t allow subsequent caregivers relying on EMR charts to get a true and accurate picture of a prior caregiver’s true thoughts. Apparently, quicker and easier input does not always translate into better or more accurate information.

Think I’m making this one up? Here’s what one internist at Harvard Medical School had to say about EMR’s:

Harvard Medical School internist and entrepreneur Dr. Rushika Fernandopulle says that many EMRs are designed to improve coding and maximize reimbursements, often at the expense of clinician functionality. “When you’re trying to read the notes of your colleague [in an EMR], it’s almost impossible to figure out what happened to the patient,” Fernandopulle tells the Journal. “You have to read through two pages of all this junk that’s put in to increase billing.”

  • Notwithstanding the claims of EMR advocates, many in healthcare and related fields firmly believe that EMR’s are not safe and secure. They point out that despite encryption and restricted access through log-in’s via usernames and passwords, there are numerous and disturbing instances of hackers gaining access to private patient information.

• November 26, 2007, Canada. Hackers accessed medical information on HIV and hepatitis from a Canadian health agency computer.
• September 22, 2008, UK. The National Health Service (NHS) reported the loss of 4 CDs in the mail containing information on 17,990 employees.
• September 30, 2008, US. The company Blue Cross and Blue Shield of Louisiana confirmed breach of personal data, including Social Security numbers, phone numbers and addresses of about 1,700 brokers. The data was accidentally attached to a general email.

(source: The HWN Team @ HealthWorldNet.com)

  • computer-driven healthcare is potentially hazardous to one’s health. Rather than paraphrase, let me share one comment I found on a blog extolling the virtues of EMR’s:

Try telling that to a computer: I am on medication that I take every three days. So, a normal 30 day supply last[s] me 90 days. However, the computer at my pharmacy automatically renews the prescription and I get a phone call every month asking me to come pick it up. I now have a year’s worth of pills on hand and they’ll expire before I can take them (which means I should not take them as they may not be effective). So, I called on Friday to tell them that I wanted to opt out of the system. The nice person informed me that I had been removed from the system. 9:01 AM Today (Monday) I got a call, telling me that my prescription is ready to be picked up. This is what happens when people cede thinking and into the ‘computer said it so it must be true’ mindset that we’ve all experienced from time to time to maddening effect.

  • way too much information, a lot of which is purely redundant and distracting. From my perspective as a lawyer, this is a major problem with EMR’s. A click of a radio button or a selection from a drop-down menu often generates duplicate entry data in a host of other fields across the system. As you try working your way through the jungle of screens or paper generated by EMR’s, you say to yourself, “Didn’t I just read that same thing somewhere else?” Now put yourself in the shoes of a healthcare provider. You have a number of patients to see, orders to give, reports on patients to share, calls from your pager to answer – and all you want to know when checking a patient’s EMR is some key information so you can do what needs to be done and move on. What do you find? More information than your ever wanted or needed and at times conflicting information. Frustration mounts and you yearn for the days of color-coded, hand-written charts.
  • How fast can you type? Simple but real issue for apparently many in the medical profession. EMR’s are meant to save time – perhaps not!
  • How fast do the records load? Some have become frustrated when using internet portals for records with very slow loading time of EMR’s when using over-utilized internet connections during peak usage hours.
  • those developing the EMR software failed to consult with practitioners before rolling out their product leading to templates, care strategies and selection choices that have no practical use for actual caregivers.

Just as is the case with the pro’s, there are many more con’s being voiced throughout the internet by medical care providers. That being said, I am of the firm belief that one of the biggest flaws is the manner in which EMR’s were and continue to be implemented – rolled out for use – in our medical institutions and physician offices. This can range from lack of training, lack of quality control, lack of system-wide coordination – you name it. In the rush to purchase, upload and put in use EMR’s, too little thought seems to have been given too many times to such projects before implementation. After the implementation, many problems started to rear their ugly heads.

Here are but a few examples of poor implementation voiced by a nurse, Kaye, in a comment she posted to the first installment of this series. Make sure to take particular note of Kaye’s fourth point!

1. Facilities are not getting input from the potential users before purchasing. Cost and JC compliance is more important than usability. “Here is your new system. Make it work.”
2. Seasoned nurses and ancillary staff are not given the considerations derserving of the huge technological changes. It’s a whole other language. A COW (Computer On Wheels) stands in the field.
3. A culture clash has developed between nursing and the IT department who cannot appreciate the urgency of correcting problems.
4. At my facility, there are 3 different systems. They don’t ‘talk’ to each other. Whose idea was that?

I could go on; but you get the point.

In my next installment, I will share with you with more real-life examples of just how misleading, inaccurate and unsafe EMR’s can be. Just to give you a tease – how about the case of a woman who was paralyzed following an epidural for labor and post-childbirth pain relief. Hours after she was diagnosed by a neurologist as having suffered injury to her spinal cord leaving her with significant, devastating motor deficits and sensory loss, she was noted by a nurse in the EMR to be “ambulating [i.e. walking] x 2″? I wonder if that would have happened if the nurse had to hand-write that entry and not just click on a drop down menu choice. There will be plenty more examples of such just how effective and safe EMR’s have turned out to be. Stay tuned and tune in to Part III coming next week.

Related Posts: Medical Technology and Patient Safety: EMR’s, COW’s, iPads, etc. – are they really doing the job? Part I.

 

The Week in Review: did you miss last week’s posts on health, safety, medicine, law and healthcare?

Sunday, April 3rd, 2011

Last week we launched the first in a series called The Week in Review. We hope you enjoy this project as a way to catch-up on what  you may have missed in the world of health, medicine, patient safety, law and healthcare. Now for our second installment.

 

Yesterday is history. Tomorrow is a mystery. And today? Today is a gift. That’s why we call it the present.”

Inspirational  Quote from Babatunde Olatunji


 

We started the week with Part I in a series of posts intending to explore the issue of whether the ever-growing and expanding advances in medical technology are really accomplishing their goal – or what should be their goal: more efficient, effective and safe delivery of medical care.

The author, Brian Nash, poses the question, “What has technology done to improve healthcare?” Answering in part his own question, he states:

The answer, in short, is – some amazing things and some not so amazing things have taken place in terms of technological advances in healthcare. Unfortunately, as we will explore in this series, some of these technological advances have led to some catastrophic results for patients. One need look no further than how the medical institutions rushed to implement the newest, shiniest and “best” radiology machines and through their haste left in their wake scores of maimed and dead patients.

Read more – Medical Technology and Patient Safety: EMR’s, COW’s, iPads, etc – are they really doing the job?

 

Wednesday’s post by Sarah Keogh explored an often discussed but apparently not always heeded message about car seat safety. Sarah offers some “tips” and suggestions on how to implement simple safety steps to decrease the likelihood of injuries to children while in our cars. She reported -

A recent article on healthychildren.org says that deaths in motor vehicle crashes are still the leading cause of death for young children.

Don’t let this message go unheeded. These are not Sarah’s “tips and tricks” but those of experts in the field of child safety.

Read Sarah’s piece – 4 Tips for Car Seat Safety.

 

The end of last week brought an “interesting” piece by Mike Sanders, also a lawyer with our firm, concerning a so-called study suggesting a possible link between religious activity and obesity. This wasn’t – Mike is quick to point out – a “theory” of his. This was a posting he saw and just couldn’t stop himself from writing about.

While I am usually reluctant to belittle medical research, this study really has me scratching my head and asking, “Who cares?” Before anyone decides to skip church this weekend, let’s look at the details of the study.

Makes one wonder what it takes in today’s world of instant news, internet publishing and blog posting (hmmm), to “get published” as a study.

Read Mike’s piece entitled Can Religion Make You Fat?

The Week Ahead

This coming week will have among its postings Part II in the series about Medical Technology and whether it is doing its job of advancing the safe delivery of healthcare to our population. We’ll start with a topic that is near and dear to all in the healthcare industry – EMR’s – better known as Electronic Medical Records. Sounds like a good idea – right? Since we live in a world of computers, radio buttons and drop down boxes and way too many of us in the field of medical malpractice litigation have made too many visits to the eye doctor from having to reading hand-written medical charts – why wouldn’t this be the next best thing to sliced bread? Well – read Part II coming this week.

We also plan on posting some information and analysis of a medical/anesthesia procedure – the epidural – that thousands of women have every day of every week throughout this country and the world. Well, are they really as safe as some would have you believe? Stay tuned and read our upcoming post.

There are likely to be even more goodies on health, law, patient safety and healthcare in next week’s The Eye Opener from Nash & Associates.

 


Medical Technology and Patient Safety: EMR’s, COW’s, iPads, etc. – are they really doing the job? Blog Series – Part I

Monday, March 28th, 2011

Medical Technology - source: Siemens.com

This is the first installment of a series of posts on issues relating to new advances in medical technology and how they may affect patient health and safety – not always for the good. Unless you live in a cave or just don’t care, you must have noticed news reports about how the medical industry is awash in the creation and implementation of new technologies. Presumably these new medical tech toys and gadgets are intended to advance the timely, enhanced, cost-effective delivery of healthcare with the end point being improved patient care and patient safety. The question is – do they always do that or can they, in fact, be tools the lead to patient injuries and – at times -even death?

I recently came across a posting by Dr. William L. Roper, MPH, CEO of the University of North Carolina Health Care System, which was in essence a transcript of a speech he gave at the Agency for Healthcare Research and Quality (AHRQ) in Washington, D.C. on March 23, 2011. Among his other vast accomplishments, in the spring of 1986, he was nominated by President Reagan and confirmed by the Senate for the position of administrator of the federal Health Care Financing Administration, with responsibility for the Medicare and Medicaid programs nationally. For the previous three years, he served on the White House domestic policy staff.

I bring Dr. Roper’s recent remarks to your attention since they are the inspiration for this series of blogs. While Dr. Roper’s address did not specifically address topics such as EMR’s, COW’s (still wondering how a cow fits into this topic? Stay tuned!), and the like, the following selected excerpts are the seeds of thought for the present series:

I have the job of leading an academic medical enterprise, and am challenged by the task of putting lofty ideas into practice at the local level. I remain very committed to the effort, but we are daily challenged to put the best ideas into practice.

The Institute of Medicine, under Sam Their’s and then Ken Shine’s leadership, played a very important role across the decade of the 1990s, defining “quality” in health care, and pointing to problems in quality and patient safety. Bill Richardson led a multi-year IOM initiative that included the groundbreaking report, To Err is Human in 2000, and then Crossing the Quality Chasm in 2001.

These reports were a clarion call for action – especially making the point that a systems approach was required to deal effectively with these issues.

While Dr. Roper’s speech was, in large part, an historical analysis of progress in the Medicare healthcare delivery system, it is also a well-versed commentary on the so-called advances in medicine for patient care and safety. Why else have so many toiled for so long in trying to find system-failures and methodologies for eradicating those failures and thereby improving the delivery of safe, efficient and effective healthcare?

Dr. Roper and so many other dedicated healthcare professionals are faced daily with the same issue – “…challenged by the task of putting lofty ideas into practice at the local level . . . [W]e are daily challenged to put the best ideas into practice.” Put another way – at least for me – taking public healthcare policy and practices and making a better widget.

As these lofty concepts were debated, published and analyzed, technology streaked along with its new bells and whistles at what some might call an amazing – almost mystifying – pace. Did you really envision yourself 25 years ago sitting with your iPhone or iPad and scouring the world’s news, chatting with your friends and followers on the other side of the planet, watching the latest streaming video of March Madness or sharing every random thought you have on Twitter or Facebook?

What has technology done to improve healthcare?

The answer, in short, is – some amazing things and some not so amazing things have taken place in terms of technological advances in healthcare. Unfortunately, as we will explore in this series, some of these technological advances have led to some catastrophic results for patients. One need look no further than how the medical institutions rushed to implement the newest, shiniest and “best” radiology machines and through their haste left in their wake scores of maimed and dead patients. We reported on this investigation by NY Times reporter, Walt Bogdanich  in Eye Opener, over a year ago.

Just over the course of the last year or so, our firm has been involved in case after case in which this issue of medical technology and patient care/safety keeps rearing its ugly and devastating head. We will share with you (leaving identifying information obscured as we are required to do) tales of just how medical technology can impact – positively and (unfortunately) negatively patient health and safety. We’ll analyze and discuss our views on just how well medical technology and its implementation (more the latter) have, in our view, negatively impacted – all too often – patient health and safety. We invite you to follow along as we consider the good, the bad and the ugly of medical technology such as EMR’s, COW’s, iPads and the like. Please join us and share your comments along the way.

Some related posts to get you started:

The Radiation Boom – Radiation Offers New Cures and Ways to Do Harm

FDA Unveils Initiative To Reduce Unnecessary Radiation Exposure from Medical Imaging

At Hearing on Radiation, Calls for Better Oversight

Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging

The Story of How a New York Times Reporter – Walt Bogdanich – Has Made a Real Difference in Medical Device Radiation Safety