Patients' welfare is at stake in the electronic effort, experts say.

  1. Kaiser has aches, pains going digital
    Patients' welfare is at stake in the electronic effort, experts say.


    Kaiser Permanente's $4-billion effort to computerize the medical records of its 8.6 million members has encountered repeated technical problems, leading to potentially dangerous incidents such as patients listed in the wrong beds, according to Kaiser documents and current and former employees.

    At times, doctors and medical staff at the nation's largest nonprofit health maintenance organization haven't had access to crucial patient information, and system outages have led to delays in emergency room care, the documents show.

    Other problems have included malfunctioning bedside scanners meant to ensure that patients receive the correct medication, according to Kaiser staff....


    ...Kaiser officials acknowledge that Health Connect has had technical challenges but say those have been resolved and patient safety has never been compromised. Patients should feel safe getting care at any Kaiser facility, they say.

    They add that medical staff revert to paper records and established downtime procedures when the new computerized system isn't available.

    "This is one of the largest and most ambitious efforts anywhere in the world to modernize our healthcare system," Kaiser Chief Executive George Halverson said. Considering that, he said, "it couldn't be going better."...

    ...A 2005 study in the journal Pediatrics found that when the Children's Hospital of Pittsburgh installed an electronic medical system several years ago, mortality increased from 2.8% of patients to 6.6%....

    ...Four years ago, Cedars-Sinai Medical Center in Los Angeles suspended its multimillion-dollar computerized physician order system after doctors complained it was possibly endangering patient safety and required too much work....

    http://www.latimes.com/news/printedi...186,full.story
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  2. 16 Comments

  3. by   Shamira Aizza
    Well, I'm sure Ted Kennedy has good intentions when he wrote the law requiring the development of electronic medical records.
  4. by   pickledpepperRN
    Quote from Shamira Aizza
    Well, I'm sure Ted Kennedy has good intentions when he wrote the law requiring the development of electronic medical records.

    Do you have a link to the law you are referring to?
    I don't see a law referred to in the article.

    I have heard Senator Kennedy, Senator Clinton, and President Bush claim technology will decrease medical errors. Is there really such a law?

    I think safe staffing will do so much more.

    And some technology is helpful while other technology is harmful.

    Substitution a machine for a nurse or doctor is a big mistake in my opinion.
  5. by   Batman24
    For all the money they are spending on this system they could have hired more medical help right across the board. Shame that all this money goes to patient surveys and inadequate computer systems when so many places are understaffed. Seems many places are willing to try anything except hire more help.
  6. by   gr8greens
    Quote from spacenurse
    Kaiser has aches, pains going digital
    Patients' welfare is at stake in the electronic effort, experts say.


    Kaiser Permanente's $4-billion effort to computerize the medical records of its 8.6 million members has encountered repeated technical problems, leading to potentially dangerous incidents such as patients listed in the wrong beds, according to Kaiser documents and current and former employees.

    At times, doctors and medical staff at the nation's largest nonprofit health maintenance organization haven't had access to crucial patient information, and system outages have led to delays in emergency room care, the documents show.

    Other problems have included malfunctioning bedside scanners meant to ensure that patients receive the correct medication, according to Kaiser staff....


    ...Kaiser officials acknowledge that Health Connect has had technical challenges but say those have been resolved and patient safety has never been compromised. Patients should feel safe getting care at any Kaiser facility, they say.

    They add that medical staff revert to paper records and established downtime procedures when the new computerized system isn't available.

    "This is one of the largest and most ambitious efforts anywhere in the world to modernize our healthcare system," Kaiser Chief Executive George Halverson said. Considering that, he said, "it couldn't be going better."...

    ...A 2005 study in the journal Pediatrics found that when the Children's Hospital of Pittsburgh installed an electronic medical system several years ago, mortality increased from 2.8% of patients to 6.6%....

    ...Four years ago, Cedars-Sinai Medical Center in Los Angeles suspended its multimillion-dollar computerized physician order system after doctors complained it was possibly endangering patient safety and required too much work....

    http://www.latimes.com/news/printedi...186,full.story

    My facility has recently gone to passing meds by computor........what a mess. We were told that the first 2 weeks we'd have plenty of support staff and tech help. BS! Day one and 2 were great with staffing and tech support. Day 4 we were left w/ 6 rns...no cna's/ pct's to help w/ lights or baths. Our pt loads were either 5 or 6 tele pts. tech support "was a phone call away".....doesn't help unless they are at your side right then and there.....pretty hard to describe a problem when you don't know how to!!!!!
    The committee heading this new med sysyem thinks everything is going well. They ARE NOT listening to the actual med passers. The hospital pharmacists are pulling their hair out too.
    The training we received before going live was inadequate....support remains inadequate.....but the CEO thinks everything is hunky-dory. Lots of bugs still need to be fixed with this system.
    We told our MDs that we are spending less time w/ their pts.....they are aware, seem supportive.
    The best thing.........we go live in June w/ computorized lab entry and retreival, pt specific order (adl/activity/etc..), pt tranfers.....others I can't recall. Administration has not adequately prepared any of us for this new transition to computorized care. They have not taken our feedback seriously enough to act on. If they did, we'd have alot more staff and support than we do.
    Sorry for the rant. :imbar
    Last edit by gr8greens on Feb 19, '07
  7. by   Kyrshamarks
    From 2004:

    This year President George W. Bush announced his goal to achieve electronic medical records (EMRs) for most Americans within a decade (by 2014). The publication of National Coordinator for Health Information Technology David Brailer's "Framework for Strategic Action" in July of this year outlined a comprehensive plan for the nationwide implementation of EMRs.
    Dr. Brailer's plan outlined four major goals:
    1. <LI class=copy>Inform clinical practice; <LI class=copy>Interconnect clinicians; <LI class=copy>Personalize care; and
    2. Improve population health.
    http://www.amda.com/publications/car...ative_tech.cfm


    There is no federal law requiring an EMR. There is a governmental push towards using EMR and its adoption into the healthcare setting. If anyone is interested i can give you plenty of links to white papers and reviews of articles about implementing an EMR in an outpatient setting and the required statues and regulations.
  8. by   pickledpepperRN
    Quote from Kyrshamarks
    From 2004:

    This year President George W. Bush announced his goal to achieve electronic medical records (EMRs) for most Americans within a decade (by 2014). The publication of National Coordinator for Health Information Technology David Brailer's "Framework for Strategic Action" in July of this year outlined a comprehensive plan for the nationwide implementation of EMRs.
    Dr. Brailer's plan outlined four major goals:
    1. <LI class=copy>Inform clinical practice; <LI class=copy>Interconnect clinicians; <LI class=copy>Personalize care; and
    2. Improve population health.
    http://www.amda.com/publications/car...ative_tech.cfm


    There is no federal law requiring an EMR. There is a governmental push towards using EMR and its adoption into the healthcare setting. If anyone is interested i can give you plenty of links to white papers and reviews of articles about implementing an EMR in an outpatient setting and the required statues and regulations.
    Thank you.
    I didn't think there was such a a law.
    Someone would have posted it here.
  9. by   Shamira Aizza
    We all remember the arrival of HIPAA in 1996; it turned into a confidentiality quagmire for most of us, but it was originally intended to be a driver make health information 'electronic.'

    It was authored by Ted Kennedy and Kassebaum...and it was named after them.

    It's intentions were good, but it's effects are painful.
  10. by   pickledpepperRN
    Quote from Shamira Aizza
    We all remember the arrival of HIPAA in 1996; it turned into a confidentiality quagmire for most of us, but it was originally intended to be a driver make health information 'electronic.'

    It was authored by Ted Kennedy and Kassebaum...and it was named after them.

    It's intentions were good, but it's effects are painful.
    Thank you.
    I think nurses and our organizations need to educate our elected representatives.
    And to work together to lobby for laws that improve healthcare and against those that degrade healthcare.

    Technology can be skill enhancing or skill degrading.

    Neither Kaiser nor any other provider is required to purchase such technology by law.
  11. by   pickledpepperRN
    Quote from Shamira Aizza
    We all remember the arrival of HIPAA in 1996; it turned into a confidentiality quagmire for most of us, but it was originally intended to be a driver make health information 'electronic.'

    It was authored by Ted Kennedy and Kassebaum...and it was named after them.

    It's intentions were good, but it's effects are painful.

    I don't think there have been any prosecutions regarding HIPPA. Privacy is truly a valid concern.

    Warnings Over Privacy of U.S. Health Network

    … In the report, the Government Accountability Office, an investigative arm of Congress, said the administration had a jumble of studies and vague policy statements but no overall strategy to ensure that privacy protections would be built into computer networks linking insurers, doctors, hospitals and other health care providers…


    http://www.nytimes.com/2007/02/18/wa...in&oref=slogin
    Last edit by pickledpepperRN on Feb 21, '07
  12. by   Shamira Aizza
    Not following you.

    Like I said, it was not originally intended to be a driver for privacy issues, but as a vehicle to expand electronic collection of data, i.e. patient records.

    And when I say quagmire, I mean that in spite of few criminal convictions, it still results in billions being spent annually to ensure compliance. That is a more reasonable benchmark rather than a conviction rate.

    It seems that a facility is being criticized for attempting to do what it's legislators have taken a strong position on. I say, keep it in perspective, or spread the blame around instead of targeting a facility.
  13. by   pickledpepperRN
    Quote from Shamira Aizza
    Not following you.

    Like I said, it was not originally intended to be a driver for privacy issues, but as a vehicle to expand electronic collection of data, i.e. patient records.

    And when I say quagmire, I mean that in spite of few criminal convictions, it still results in billions being spent annually to ensure compliance. That is a more reasonable benchmark rather than a conviction rate.

    It seems that a facility is being criticized for attempting to do what it's legislators have taken a strong position on. I say, keep it in perspective, or spread the blame around instead of targeting a facility.

    I am confused.
    HIPAA does not require any technology to my knowledge:
    http://www.hhs.gov/ocr/privacysummary.pdf

    Were there any criminal convictions?

    Is there any law or regulation requiring computerized medical records.

    And it is still the owners responsibility to manage their facilities.

    I think it is appropriate to try to prevent errors leading to potentially dangerous incidents such as patients listed in the wrong beds.
  14. by   Shamira Aizza
    Now I understand what you were saying.

    What I was clarifying was that this criticism of the evolution of digitization of health care data was politically driven, specifically via HIPAA.

    HIPAA was not originally intended by it's founders to become the privacy monster that it became; it was originally intended to be an incentive to reduce paper records and increase the use of electronic data storage of patient information.

    My intention was to just point out that these facilities are simply attempting to get in line with the expectations of the politicians who write this legislation.

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