The work reported yesterday has triggered a major reaction from all over.
From the Sydney Morning Herald we have:
Patients put at risk by software
Julie Robotham
March 7, 2011
THE computer system that runs emergency departments in NSW hospitals is compromising patients' care, according to the first systematic review of the troubled project that found it was crippled by design flaws.
The FirstNet system allows treatment details and test results to be assigned inadvertently to the wrong patient, according to the review. It is based on a technical study of the software and interviews with directors of seven Sydney emergency departments.
The system is so compromised it should be scrapped, a specialist doctors' group said yesterday.
Difficulties retrieving patient records could delay treatment, and the system - on which $115 million has been spent - automatically cancelled pathology and radiology requests if the person was transferred from the emergency department without checking whether these were still needed, according to the study by Jon Patrick, the director of the University of Sydney's health information technology research laboratory.
Sally McCarthy, the president of the Australasian College for Emergency Medicine, said Professor Patrick's findings confirmed that the system, loathed by doctors and nurses, was unsuitable for its purpose.
''When do we stop throwing good money after bad?" said Dr McCarthy, who heads the emergency department at Prince of Wales Hospital. "Anything that takes staff off the floor to spend their working time on an inefficient IT system is a detriment to patients."
The project, part of a 10-year electronic medical records plan intended to make patient histories, X-rays and test results accessible from any hospital in the state, had proceeded too fast - apparently because of contractual obligations - for clinicians' feedback to influence it, Dr McCarthy said.
Lots more here:
We also have some very interesting US reaction:
From here:
For March 7 we have:
From Aussie: “Re: Jon Patrick’s article. Mr. HIStalk, I have never seen a dissection (without anesthesia) of Cerner going to this depth. Unbelievable, although in the USA, one would be professionally dead in the HIT industry if even contemplating talking about these long known issues. Hope you will have the courage to publish something about it.” Professor Jon Patrick of the Health Information Technologies Research Laboratory of University of Sydney expands his writeup (currently in draft) about problems with the implementation of Cerner FirstNet in emergency departments in New South Wales.
You’ll love it if you sell against Cerner because everybody from doctors to software validation experts tears into FirstNet (and, by implication, Millennium in general) from every angle — usability, software and database design, and implementation methods. FirstNet competitors could create a fat anti-Cerner prospect piece just by excerpting from it.
On the other hand, I wouldn’t say it’s necessarily unbiased, it focuses on implementation of a single department application that didn’t go well for a variety of reasons (despite many successful FirstNet implementations elsewhere), it uses the unchallenged anecdotal comments of unhappy users who make it clear they liked their previous EDIS better, and it nitpicks (I wasn’t moved to find a pitchfork when I learned that the primary keys in the Millennium database aren’t named consistently).
But it is interesting when it tries to associate user-reported problems with observed technical deficiencies, such as why information known to have been entered sometimes disappears (problems with non-unique primary keys and referential integrity are mentioned – certainly the latter is a problem with many systems).
In other words, it’s not just about Cerner or some ED project in Australia. The real message is that design and support patient care software is the Wild West at this point since we’re arguably still in the first generation of systems claiming to be clinical (even though they often are really business systems masquerading as such).
Lots more of this article is on the site.
Also Scot Silverstein blog has been busy:
See
http://hcrenewal.blogspot.com/2011/03/what-to-do-about-state-of-ed-ehr-in-nsw.html
http://hcrenewal.blogspot.com/2011/03/on-emr-forensic-evaluation-from-down.html
I am sure more will follow. A big reading day.
The links to the original report is found here:
http://aushealthit.blogspot.com/2011/03/professor-jon-patrick-pops-his-head.html
Enjoy all the reading.
David
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