Perhaps in the old system, the doctor could write: CMP in AM Now in the new system, perhaps they would be expected to manually select each of the individual lab tests from this usual package, as there was no "order set" established.
Very likely, the new method takes at least 4-5 times longer to do, and physicians are unwilling to switch from patient care to computer care. So they get someone else to type on the computer for them, and we are back at step 1. <soapbox> There is a lot of enthusiasm and hype for these systems that really doesn't always pan out, in my opinion. For example, at our hospital, they decided to be up with the times and purchase a nifty medical record system. Well, I doubt that the system they bought has been used by very many hospitals. This is a relatively new field, and companies put together a new product and go looking for customers. This particular system tries to graph out vitals to show the doctor the temperature curves. But it forgot to put a usable scale on the graph, and the scale changes depending on different circumstanses. So it is essentially useless. Also, it doesn't allow a fine tuning of the range of the data to be displayed. I tried working with the hospital to get this working, but they couldn't fix a problem in a commercial package they had bought. The scale that the company provided was non standard (and plain wacky!), and neither I nor the nursing supervisor could extract meaningful numbers from the graph. So in the end, I had to create an end-run around administration and get our medical staff to require the nuring staff to take the data back ouf the computer and manually graph out temperatures so that a doctor can see when their patients are spiking temps. One can't (or it is very difficult) pick out these patterns when the numbers are presented in tabular fashion. So here is an example of a good idea, that didn't quite make it. And as a result it does more harm than good. And this is just one aspect of implementation of a very complex situation. And by the way, this is a side-ways plug for VistA. It has been around long enough, in day-by-day use, that many of these quirks/bugs have been worked out. So back to the article mentioned. Well intentioned IT people helped the hospital pick out software. Had meetings with nursing staff etc. etc. in attempts to prepare for that great go-live date. It arrives and "oops", someone forgot to get the system 100% up to speed. And apparently someone died as a result. I am very skeptical that people not actively working in a situation are able to anticipate or appreciate the relative importance of the needs of an actual user. From my example above, some programmer probably found a graphing .ocx and dropped it in. Job done, right? So when I find quality "improvement" people pushing physicians towards a new method that they are just certain is much better, I'm a bit skeptical. It might be better if England stopped their "backwards" way of driving on the left hand side of the road. Starting 1/1/2006, everyone there should start driving on the right hand side of the road. QED, eh? </soapbox> Kevin On 12/5/05, Mike Ginsburg <[EMAIL PROTECTED]> wrote: > This sounds like an implementation issue. The sentence in the article that I > don't understand is: "no ICU-specific order sets had been programmed at the > time of CPOE implementation, but instead were developed over time after CPOE > implementation." Does this imply that procedures that were ordered manually > before the system was implemented somehow were overlooked after the > implementation? > ------------------------------------------------------- This SF.net email is sponsored by: Splunk Inc. Do you grep through log files for problems? Stop! Download the new AJAX search engine that makes searching your log files as easy as surfing the web. DOWNLOAD SPLUNK! http://ads.osdn.com/?ad_idv37&alloc_id865&op=click _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members
