Wednesday, March 17, 2010

A Simple Lesson for the Health IT Industry

From an Op Ed "Living with the Electronic Car" in today's Wall Street Journal:

"A Toyota executive recently explained to a Congressional committee investigating claims of uncontrolled acceleration: "We need to reduce the number of things we ask our customers to do correctly." In fact, the exec was describing the essence of responsible engineering - though perhaps the balance in auto design has gotten out of whack."

Considering the feedback from physicians on the needless complexity of electronic medical records and other computerized medical devices for example at "An Honest Physician Survey on EHR's", it seems the healthcare IT industry has yet to learn this simple lesson.

I'm frankly not convinced there's "anyone home" in this complexity-loving industry who could fathom such advice as a good business practice.

It also seems that industry may not give a damn about such lessons, even in the most safety critical of environments, the intensive care unit, as long as profits are maintained.

See for example "A Lawsuit Over Healthcare IT Whistleblowing and Wrongful Discharge: Malin v. Siemens Healthcare." Also see "Third-Party Reviews of Medical Devices Come Under Scrutiny at the FDA - Except Healthcare IT Medical Devices, Which Get Special Accommodation" on political maneuvering by this industry to avoid the federal regulation other healthcare drug and device sectors have been subject to for decades (largely as a result of public health disasters such as this and this, I might add).

The interesting aspect of these issues is that the executives and officials behind these decisions and machinations are setting themselves up as near-indefensible defendants in future litigation by patients (and their estates) harmed or killed by healthcare IT-related problems.

For instance, I had communications with the Joint Commission leadership over issues I raised in my July 22, 2009 JAMA letter to the editor "Health Care Information Technology, Hospital Responsibilities, and Joint Commission Standards." Namely, on how hospital executives were violating their fiduciary and Joint Commission safety standards obligations, and jeapardizing patient safety, in signing the traditional health IT contract calling for confidentiality about health IT malfunctions and defects. The JC Leadership is quite well aware of this letter and my more thorough essay here.

Nothing has been heard from the Joint Commission on these issues since.

Perhaps never before have the malpractice lawyers been provided a better scenario for taking the houses and personal property from irresponsible and/or conflicted healthcare and health IT regulators and other officials via lawsuits as health IT diffusion increases, with its "tip of the iceberg" injury and death occurrences now firmly established.

-- SS


Anonymous said...

The Joint Commission is to hospitals as CCHIT is to HIT vendors. They both provide an illusion in the form of an "accreditation" or "certification" to the unsuspecting public that the product being produced is safe.

Unknown said...

A friend of mine is a nurse and was recently discharged from a well known florida hospital for what I guess could be called "whistleblowing." Of course, the employer never used that term or made that accusation. They seem to have fabricated grounds for dismissal Plus, Florida is a "right to work" state. The phrase sounds great for workers, however, what it really means is that you can be fired for about anything. He [the nurse] reported mis-use of patient information. Supposedly, he overheard an administrative worker giving out private information in response to numerous calls from a medical employment marketing agency. His previous attempts to report it internally were ignored.