MrHISTalk, who’s blog is fantastic, out-does himself in an article about the University of Pittsburgh Children’s hospital CPOE implementation, which has had so much publicity since the article was released on Monday.
His article is called, Does Cerner Millennium kill children? I don’t think so. It’s not betraying his anonymity to tell you that MrHISTalk is a hospital IT director with a great deal of experience in pharmacy. He’s an expert, so go read it.
I have little to add other than three quick thoughts:
1) The before and after study may have studied a period too early in the CPOE implementation. It takes time to get the new processes down, and things may have got better later. But not in the timeframe of this study, apparently.
2) Last weekend I heard a doctor complaining bitterly about having to use an EMR in the outpatient setting, claiming that it imposed secretarial tasks on him, and interfered with his relationships with his patients. I’d counter by saying that in ambulatory care the recording of what happens in the exam room and the presentation of information from there and other venues (labs, medication) etc matters more to the care of the patient than the information that the doctor actually imparts there, 90% of which the patient forgets about when they walk out the door — something physicians don’t on the whole realize. In the ICU, what happens in the room is often a matter of life and death, so the interference that the recording of the information puts in the way of the process may have a bigger impact.
3) IT implementations are not easy. Paper does kill. Of course it’s not just paper that kills, it’s poor processes with or without IT. But the option of ignoring IT is not an option. The industry needs to do much more work about getting this right.