"Dumb Docs"... Ouch. That seems like an unwarranted slap. Of course all errors that occur are because the doctor is "dumb", right?
Kevin --- Thurman Pedigo <[EMAIL PROTECTED]> wrote: > It's already on the WIRE: > http://www.wired.com/news/medtech/0,1286,67639,00.html?tw=wn_tophead_6 > Computers No Cure for Dumb Docs 02:00 AM May. 26, > 2005 PT > > What is interesting about this article is it comes > from the back yard of > Intermountain Healthcare (IHC) and Brent James,M.D., > the legendary medical > quality guru who has probably impacted our health > systems to save more lives > than almost any living clinician. It was his study > that set the standards > for pre-operative prophylactic antibiotics in the > 80's. Among other of his > accomplishments is the demonstration that adverse > drug events (ADE) jumped > from 15/year in the 80's (detected by incidence > reporting), to 580 in 1991 > when IT was added to the equation. Few reporting > environments are as open in > reporting weaknesses as this group (IHC and VA). > > In this (Archives) study, only 1% of all ADEs were > documented in the allergy > and adverse reaction section of the record. It's > also important to note that > only 1% of all the errors were dispensing and 0% > transcription. The authors > point out the need for decision support if we are to > further impact ADEs. > > Thanks, > > thurman > > > > > > -----Original Message----- > > From: [EMAIL PROTECTED] > [mailto:hardhats- > > [EMAIL PROTECTED] On Behalf Of > Nancy Anthracite > > Sent: Sunday, May 29, 2005 12:07 AM > > To: [email protected] > > Subject: Re: [Hardhats-members] Archives of > Internal Medicine Article > > > > It was pointed out in the article, and I should > have mentioned it, the the > > reason the counts were high is because the system > was able to identify > > them. > > > > It also mentioned that drug interactions were > checked, although the > > interaction checking was not described inthe same > detail as you described > > it. > > The article said that other things, like making > sure a checks of serum > > potassium were ordered for the future for patients > started on Lasix, were > > not > > implemented. It was not blaming the records system > for causing the high > > numbers, but it was indicting it for not having > better decision support to > > prevent the high numbers. > > > > As I understand it, some of that sort of decision > support is implemented > > but, > > as you can imagine, the amount of decision support > that is available on a > > system could vary very widely in type, amount and > quality from system to > > system. Readily available, targeted order sets > were felt to be one way to > > cut > > down on these problems. > > > > On Sunday 29 May 2005 01:26 am, Chris Richardson > wrote: > > > Nancy; > > > > > > There is drug/drug, alergy, and drug/food > interaction associated with > > > orders (OR*). At the hospitals, drug orders are > written by physicians > > > (bolstered by CPRS) and must be reviewed and > signed by a pharmacist. > > Then > > > the point of care interface, Bar Code Medication > Administration (BCMA) > > > system (PSB*) also is another check to make sure > that the proper drug is > > > given in the proper dose at the proper time to > the proper patient. The > > > nurse is the final check on the delivery of the > drug and records the > > result > > > of the administration (dose given/patient > refused/etc). > > > > > > Please remember that the increased counts are > a measure of looking for > > > these errors as well as having automated methods > of the recording of the > > > dispensing of the drugs. The actual count of > drug errors in hospitals > > > where these automated methods are not used may > never be known. If drug > > > delivery cannot be measured in a meaningful way, > no policy change is > > likely > > > to have much effect. > > > > > > ----- Original Message ----- > > > From: "Nancy Anthracite" <[EMAIL PROTECTED]> > > > To: <[email protected]> > > > Sent: Saturday, May 28, 2005 9:27 PM > > > Subject: [Hardhats-members] Archives of Internal > Medicine Article > > > > > > > The May 23rd issue of the Archives of Internal > Medicine had an article > > > > > > about > > > > > > > the high rates of adverse drug related events > noted in a VA Hospital. > > The > > > > lack of decision support for selection, dosing > and monitoring was > > cited > > > > as > > > > > > a > > > > > > > deficiency in the EMR that if corrected, > might prevent some of these > > > > problems. The presence of drug interaction > checking was mentioned. > > > > > > > > The abstract is here. > > > > > http://archinte.ama-assn.org/cgi/content/abstract/165/10/1111 > > > > > > > > It is my understanding that there is some > decision support already > > > > present > > > > > > in > > > > > > > VistA but it is less than the ideal according > to this article > > > > > > > > I doubt any record system out there is ideal, > but I can see this as > > > > > > something > > > > > > > that will be cited as a reason not to adopt > VistA . I bring it to > > your > > > > attention so you will not be surprised by this > also so that we can > > work > > > > toward adding more decision support to VistA > with the help of the > > medical > > > > community as it grows. > > > > > > > > I am hoping that the release of VistA Office > and the web site that > > will > > > > > > come > > > > > > > with it will be a place for the VIstA users > to debate and contribute > > > > specific decision support suggestions as well > as templates, clinical > > > > reminders, etc. I hope that users within the > VA will also be willing > > to > > > > contribute and that this will lead to > improvements in VistA for > > > > everyone's benefit. > > > > > > > > > > > > -- > > > > Nancy Anthracite > > > > > > > > > > > > > ------------------------------------------------------- > > > > This SF.Net email is sponsored by Yahoo. > > > > Introducing Yahoo! 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