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Everyone hates the electronic medical record

logicmag.io

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161–170 of 343 posts

Re: Everyone hates the electronic medical record

#161

Post by usrusr »

duffpkg wrote: post #80
persnickety wrote: post #77

Earlier quoted context omitted.

> In-N-Out instead of McDonalds, What is this comparison trying to illustrate?

A lot of facilities run on a McDonalds type thinking when they should be looking at how In-N-Out is able to deliver a very similar product that is both dramatically better and either the same price or even cheaper. In-N-Out staff is well compensated, customers rate the institution as one of the most beloved in american life. McDonalds achieves neither of those things. What makes In-N-Out different? The difference is…

That diesel maintenance example gets even more interesting when read through the lense of the ongoing Boeing threads: there, consensus is that the root problem is authority erosion for the core discipline: in old Boeing, engineering was a requirement for responsibility, but that is gone. In hospitals, the core discipline still holds on, but the blanket implicitness (or is it already a struggle? "we can't give up the diesel!"?) leads to terrible outcomes as well. Extremes rarely end well.

Re: Everyone hates the electronic medical record

#164

Post by mcosta »

dieortin wrote: post #63
JusticeJuice wrote: post #24

Earlier quoted context omitted.

The UK government tried this, wasted 12.4 billion pounds over 10 years, and ultimately wrote most the project off. The dream of an EHR is just deceptively tricky, so many smart, well-funded, well-connected teams have tried and failed. ref: https://barnett.surge.sh/welcome/intro.html

If I’m not mistaken, the Spanish healthcare system has a fully electronic medical record.

In reality it has several

Re: Everyone hates the electronic medical record

#165

Post by zie »

Stranger43 wrote: post #153
duffpkg wrote: post #123

Earlier quoted context omitted.

I am lacking all the information as to whether we are even talking about Epic but Epic is a lousy tool. It is still just a tool though. For the unititiated Epic is not some tiny little software program to manage an ICU, it's a city scale platform to run most of a hospital city. You can do a lot of good things with it and a lot of stupid things with it. If in fact orders are being randomly cancelled in the ICU that's…

In a lot of ways not legally. In and out can fire their vendor and walk away, this is nearly impossible for an public institution to do once the procurement contract is awarded, so those systems end up "too big to fail" no matter how bad or unfixable the situation is.

It just takes management with a spine. I work in the public sector, it absolutely can be done.

My guess, it's partially the softwares fault and partially the organization for trying to force a particularly bad workflow on bad software. It's probably fixable without throwing the baby out with the bathwater, but it takes someone willing to go dig in and figure it out. Those people can be hard to find in any organization, and doubly so in public sector organizations.

Re: Everyone hates the electronic medical record

#166

Post by phaedrus441 »

This article (and many like it) often mention how intuitive and speedy the Dept. of Veterans Affair EMR is. I can guarantee not a single one of these authors has ever used it. CPRS (the VA's EMR) is easily one of the biggest reasons physicians don't want to work at the VA, and most facilities have fewer patients per team (compared to academic or community hospitals) because of how much extra effort is required to use it. It is just startlingly bad.

Re: Everyone hates the electronic medical record

#167

Post by bluGill »

cutemonster wrote: post #126
rendaw wrote: post #118

Earlier quoted context omitted.

Are you saying that the cancelled orders are due to a management decision/policy, and not a software bug? Or that EMR wasn't intended for managing orders and the decision to use it in such a way was wrong? Asking as someone who's mostly unfamiliar with this. Edit - I'm trying to make sense of this thread, and it seems like this might be a reasonable summary: There's good and bad software (epic). The fact that managem…

When management insists to continue using software that: > the EMR [is] cancelling orders I placed on critically ill patients in the ICU more times than I can count then I suppose the management is a problem? Maybe more competent managers would have given the software a test run smaller scale first? And had a plan for returning to paper and pencils again, if the new software didn't work?

Competent management would atcept the report of this and scream about it. That means lawyers taking whoever is at fault to court. That means invoking the contract line to to pay (which they would have put there). That means of course a way to report things like this that any busy doctor can figure out.

Re: Everyone hates the electronic medical record

#168

Post by the8472 »

pintxo wrote: post #129
Naijoko wrote: post #116

Earlier quoted context omitted.

"99,000 americans a year die from hospital acquired infections that are entirely preventable using procedures and operations (not surgeries) that are known and evidentially proven. It's just really hard to get all of the parts of the orchestra to play the same tune so those people die needlessly." ??? I dont get this. The problem are Antibiotic resistant bacteria. You go to a Hospital (ER) and have a open wound.. cha…

No direct experience here, but afaik the solution is strict hygienic standards, constant testing and isolation of positive cases.

220nm light is under investigation since it's germicidal but so far appears far less harmful to humans than other UV ranges. If those findings are validated we might see some permanent narrow-band, low-power UV lights in hospitals.

Re: Everyone hates the electronic medical record

#170

Post by cik »

Sounds like people in a specific country, dislike a specific implementation. Clickbait.

In my country, we have and love EMRs. They enable me to change health authorities at will, as I move cities. They enable me to carry nothing, anywhere - including prescriptions. My phone can serve as my booking tool, and I have instant access to results (such as a blood test) at the same time as a doctor. EMRs enable activities - business and government decisions might limit them.

Centralization of data for me, in a socialist health care system, delivered by capitalist competition is ideal. It's allowed me to be a consumer, having my daughter's eye operation occur at a hospital far away, but her doctor, literally around the corner have access to all results, without my intervention. This is one of the best parts (by far) of living here.

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