Health care providers have relied on paper charts and handwritten notations for years. Nonetheless, there’s been an ongoing transition to a more digitized system for some time in order to provide more accurate records that could be stored, transmitted and retrieved with greater efficiency.
But a new report issued by the Institute of Medicine, a wing of the National Academy of Sciences, says that the transition has not been a smooth one. People are getting treated poorly or inadequately and some are dying. Dr. David Bates of Brigham & Women’s Hospital in Boston was one of the authors of the report and says, “In one children’s hospital in Pittsburgh, when they put in place computer order entry, which lets doctors write orders on a computer, the mortality rate among children who were transferred in to receive special care went up substantially. I will note that other hospitals around country have implemented exactly the same technology and have actually seen a reduction in their mortality rate.”
It’s not exclusively a problem with either the technology or the people operating it, says Bates, it’s a combination of two.
But if we’re going to understand how the use of technology could cause harm, we need to figure out what went wrong in places like Pittsburgh.
Dr. Ashish Jha, a professor at Harvard’s School of Public Health and an author of this report as well says, “One of things that happened in Pittsburgh, in the pediatric ICU was that when the electronic system was put in, it really changed the way doctors and nurses interacted and the way they worked together. Physicians started spending a lot less time at the bedside and they were spending a lot more time staring at the computer screen, and interacting less with nurses and interacting less with patients. And there’s a lot of information you pick up when you speak directly with people that when you go to purely electronic communication, you miss.”
As for how the system can be improved, Jha says, “Part of it is research. We have almost no data on how to safely implement electronic health record systems. So if you came to me and said, ‘I want to implement electronic records in my hospital. How do i do that in a way that doesn’t harm patients?’, we have almost no evidence base for that. So i think that’s one part of it. And then as doctors and hospitals implement these systems, we have to track very closely who’s doing it well, who’s not doing it well and then try to spread the lessons of the successful implementations.”
Jha says in the long run, we’ll be glad these systems are in place. “I think if implemented well, these technologies can have a dramatic effect on the safety of health care. We’ve seen studies that suggest electronic prescribing can reduce medication errors by 90 to 95 percent. So the promise is out there, the challenge is to do it well.”
Also on today’s program, a new website, Drinkify.org will match the music you like to the perfect beverage. We take it for a test, and not just as an excuse to put Motley Crue on public radio.
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