My mom who is an NP, (nurse then) used to say 20 years ago that the nurses are the "rememberers" and the doctors, the "thinkers". The most important job of the nurse was to remember what was going on with each patient and get the doctors up to speed as efficiently as possible.
A typical day on the ward
21–30 of 56 posts
Re: A typical day on the ward
#22This description of a typical day on the ward is of course ridiculously inefficient to us as digital natives. We deal with information flows every day and can imagine ten different systems that could do this without even opening the door to the hospital.
The big 'but' is that there are so many hidden requirements here. Privacy is a huge concern. Data on patients may not leave the hospital. With the devices we have these days, it is almost impossible to create a near offline system. Almost all devices are connected to "the cloud" in some form or another, making them vulnerable.
The fact that health insurers are grossly incompetent in this aspect does not mean that hospitals should go down to that level.
Another hidden requirement is that this system has to work, always, no matter what happens. Paper notes may not be efficient, or complete. However, you can be pretty sure that while the hospital is still standing, this system works. Making a digital system that is as reliable is a very hard task.
All this will make such a system a huge investment, not only the system itself, but also in training. Balanced against the cost, it is not so evident that this is really an acceptable investment.
Re: A typical day on the ward
#23This description of a typical day on the ward is of course ridiculously inefficient to us as digital natives. We deal with information flows every day and can imagine ten different systems that could do this without even opening the door to the hospital. The big 'but' is that there are so many hidden requirements here. Privacy is a huge concern. Data on patients may not leave the hospital. With the devices we have th…
The MVP for that system wouldn't be all patient data, it'd be just one metric or something that you could harden the system's other properties against. If you leak one metric, you probably leak them all (and the inverse is probably true). The training costs are amortized because they are dominated by one-time costs of learning the system for one metric, not all metrics.
Re: A typical day on the ward
#24Hospitals already put a bracelet on every in-patient, right? What if you had an RFID chip in the bracelets and scanned at entrances/exits to the ward, to keep track of where the patients are and have been?
why?
I think you are mis-understanding the problem, which is not where patients are but what teams they belong to and what has happened to them overnight
Re: A typical day on the ward
#25I'm in the late stages of writing up a PhD on this topic (nursing documentation in a community setting). The major problems are: 1. EHR technology is sold to managers, not clinicians. 2. The leadership of introducing the EHR is fragmented and highly dependent on local conditions such that success in one location does not guarantee success in another location. Likewise with failure. 3. Researchers have a tendency to t…
singingfish well outlined! would like to see more of the thesis. good luck!
my other problem is that I've turned into a moderately successful software developer and the phd is no longer necessary for my career. along with the politics, that creates big motivations problems for me ;)
Re: A typical day on the ward
#26This description of a typical day on the ward is of course ridiculously inefficient to us as digital natives. We deal with information flows every day and can imagine ten different systems that could do this without even opening the door to the hospital. The big 'but' is that there are so many hidden requirements here. Privacy is a huge concern. Data on patients may not leave the hospital. With the devices we have th…
I dunno about the "always works" claim. I have nothing to do with health care, per se, but I always tell everyone to factor in a base 1%-5% error rate for basic information and data entry that a human beings end up doing manually...
I imagine the number of errors/deaths/kerfuffles due to the opportunity cost of professional time, not to mention transcription and human errors of such systems are not inconsequential...even if they aren't at the forefront of our minds, and even if some of them haven't been measured accurately.
Re: A typical day on the ward
#27I'm in the late stages of writing up a PhD on this topic (nursing documentation in a community setting). The major problems are: 1. EHR technology is sold to managers, not clinicians. 2. The leadership of introducing the EHR is fragmented and highly dependent on local conditions such that success in one location does not guarantee success in another location. Likewise with failure. 3. Researchers have a tendency to t…
Hi mate,
I am a Doctor in the startup space for eHR in Australia. I would love the opportunity to further discuss what you have found during your thesis.
If you have any interest at reaching out, my contact details are in my profile.
Cheers,
Rob
Re: A typical day on the ward
#28It seems like the essentially free work done by interns/medical students is instrumental to these bad systems and procedures continuing.
I wonder what would happen if an intern group got together and said "No. This is a stupid and dangerous way of doing things. We're no longer going to turn up an hour early for a 12-hour shift to copy out notes that should have been taken in a more sensible way to start with."
Re: A typical day on the ward
#29This description of a typical day on the ward is of course ridiculously inefficient to us as digital natives. We deal with information flows every day and can imagine ten different systems that could do this without even opening the door to the hospital. The big 'but' is that there are so many hidden requirements here. Privacy is a huge concern. Data on patients may not leave the hospital. With the devices we have th…
I dunno about the "always works" claim. I have nothing to do with health care, per se, but I always tell everyone to factor in a base 1%-5% error rate for basic information and data entry that a human beings end up doing manually... I imagine the number of errors/deaths/kerfuffles due to the opportunity cost of professional time, not to mention transcription and human errors of such systems are not inconsequential...…
You are never going to take away the human from this equation. Notes are taken over the course of the day, and many of the proposed systems end up taking more time: nurses do their rounds, use pen and paper to take notes while walking around, and at the end of the shift copy the notes from the paper into the system.
This means that you have basically added another data entry level, increasing both time and error rate.
Re: A typical day on the ward
#30Earlier quoted context omitted.
Do you know the guys working on XTK [1]? They are also working out of Boston Children's Hospital. They have an awesome medical library for webGL based applications. If so, tell them I say hi! Your story reminds me of my current struggle with a massive medical company in orthopedics and when I learned to never say the word hack again. I was brand new to medical working with WebGL to create a web based bone cutter app…
Somewhat offtopic---do you have an opinion on ludei vs. phonegap, or know someone who does? Working on a js project I'd like to port to mobile, and somewhat bewildered by the choices...
PhoneGap just runs on the built-in web controls of the platform. Ludei reimplements the web control to run faster. Generally you only use the latter for games and graphics intensive apps.