Dr Horst Herb Reviews the Revised NSW Health Implementation of Cerner’s Firstnet.

I will let Horst tell the story for himself – which appeared a little while ago today on the GPCG_TALK mailing list.

Horst has given me specific permission to republish this saying:

On Tue, Mar 9, 2010 at 1:26 PM, David More wrote:

“Hi Horst,

Happy to post your account on the blog. That might get some attention. There are a lot of influential readers I understand from the feedback I get.”

Thanks.

Anything that might contribute to positive change is welcome – the status quo is not acceptable

Horst

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For those who don’t know Horst is a resident polymath on the General Practice Computing Group e-mail list being a GP in Dorrigo as well as being a very experienced system designer and implementer among other things.

Take it away Horst:

[GPCG_TALK] Cerner software - the saga continues –

From: Horst Herb

To: General Practice Computing Group Talk

I was offered AUD 400 to sit for an hour in a teleconference and see the improvements in Cerner's Firstnet software for rural hospitals, and -silly me- I accepted.

So I sat and watched.

And I left very, very angry.

In essence, they tried to convince somebody who has been using a Microwave oven for the past decade that the best way forward is to buy their (most expensive) two flint stones, because then you can bang them together, light some fire, and eventually cook on it. Actually, the analogy is wrong, because flint stones can be very useful in the right circumstances.

In detail:

at the time of entering a progress note, the doctor cannot

- browse, add or modify allergies

- browse, add or modify past history

- browse past consultations

- browse or request test results

- browse or manage medications

(in fact, the concept of medication is still alien to that software it seems) etc without leaving the data entry screen (and potentially losing all data entered so far if he leaves the screen the wrong way), navigating a complex menu that makes Homer's odyssey look like an easy travel guide for nursing home patients, and then eventually find the way back to the data entry screen.

The number of mouse clicks required to perform even the simplest tasks remains legion, and the screens remain cluttered with (to the clinician) useless administrative details while utterly neglecting the needs of the clinician.

The presentation of data (e.g. vital signs) remains in a form where it is very difficult to find what is actually relevant (even to those who are familiar with the format of the information presented in) .

This software is not just extremely poorly designed (in fact I cannot recall any clinical software I have seen in 20 years in multiple countries that was anywhere near as bad) and time wasting - it is dangerous to patients because it makes information access needlessly difficult and confusing.

It saddened me to witness that they failed to improve anything in a meaningful and significant way after so much time spent after the initial assessment, and it maddens me that they refuse to take advice on board from those who KNOW what the requirements are because they actually do the work AND have experience with other (much better) implementations.

We VMOs at Dorrigo Hospital refuse to work with that software and we fail to see any realistic way forward given the time they wasted between the last presentation and today without producing any MEANINGFUL changes. I learned that the doctor from Bellingen Hospital who was meant to watch left disgusted even earlier than I did, so I suppose the verdict there remains the same too.

Horst.

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I pass this on without comment other than to say it seems this software is just not suited for small hospitals in small towns. There really needs to be an alternative to the one size fits all approach!

David.