Wednesday, March 20, 2013

Boulder Community Hospital computer system crash: Either you're in control of your information systems, or they're in control of you

Yet another health IT crash, "prolonged" this time, from some unspecified "glitch":

Boulder Community Hospital computer system crash frustrates patients
Officials say it could take until Friday for outage to be resolved
By Brittany Anas
Camera Staff Writer
Posted:   03/18/2013 07:23:23 PM MDT
Updated:   03/18/2013 07:24:16 PM MDT

A prolonged computer system outage is preventing Boulder Community Hospital from accessing patient records -- making it difficult for people to schedule surgeries, get test results and make appointments for routine blood work.

Meditech, the system used by the hospital to manage patient records, went down in the middle of last week. It could take the hospital until Friday to get the system back up, said Rich Sheehan, spokesman for Boulder Community.

That fits my definition of "prolonged."

While information technology officials are investigating what caused the outage, Sheehan said patient records are protected and hospital officials don't believe they've been hacked. 

That's not very reassuring, considering the length of the outage.

The outage affects the hospital, its Foothills campus, eight laboratories and six imaging centers. 

Patients are on its face put at-risk ... for example, I know of several deaths of infants and adults from delayed x-ray reports alone ... but the clinicians, not the IT seller or hospital IT staff, are liable.

"We know medical care is important to people, so we understand the concerns those in the community have," Sheehan said. "We have a lot of people working on this, doing the best they can to solve this problem in a safe manner and as quickly as possible." 

"We know medical care is important to people?"  No, really?

In the meantime, the hospital is using manual paper record-keeping systems and traditional paper charts for its inpatients. Hospital officials say the system allows them to continue treating patients, provide diagnostic services and collect important clinical information that will be entered later into each patient's electronic health record.

But that concerns Eroca Lowe, whose mother was in the hospital Thursday through Sunday with gallbladder pain.

Lowe said the outage made it extremely difficult for doctors and nurses to do their jobs while hunting down lab results. She criticizes the hospital for not having a backup computer system and resorting to paper records.

"That's not a hospital in 2013," she said.

It's a good bet the paper records and HIM personnel managing them are not what they used to be pre-computer.

... Dina Huber said it took her and her significant other six days to schedule an appointment for a hernia surgery because the system used for scheduling is down.

"If they can't keep their computer system running, how can we trust them to perform surgery?" Huber said.

Fortunately, surgeons perform surgery ... not computers, IT staff or management.  Doctors, as the enablers of healthcare, don't need computers to save lives.

However, making their job harder is not a good idea.

A physician who works at Boulder Community Hospital, speaking on the condition of anonymity, said he doesn't think the outage is compromising the health or safety of patients. But, he said, the backup response "seems a little haphazard, and it's not an organized plan." He said physicians are left chasing down records.

If a prolonged outage "is not compromising safety", then why did the hospital spend tens of millions on computers?

Sheehan said the hospital is prioritizing accuracy and patient safety while getting the records system up and running. 

Once it's running again, there is significant risk of data now recorded manually being lost, thus again increasing error risk.

"We apologize for the delays, but this was an unavoidable situation," Sheehan said.

("We apologize for the chilly water, but this was an unavoidable situation." - Captain of the HMS Titanic?)

If an injury occurs, how will that sound to a jury?

Let me answer that:  like bull***.  

My response to Mr. Sheehan and Meditech, and the IT personnel involved:  "Either you're in control of your information systems, or they're in control of you."

It seems the latter clearly applies here.

I pray nobody gets injured ... and that the principals don't end up before plaintiff attorneys I've educated on the issues of bad health IT.

-- SS


Darrell said...

The hospital community could learn something from dental practices. One never hears of dentists’ computers crashing. In fact, since one doesn’t hear anything at all about the faults of electronic dental records, I think we can assume they are perfect.

Anonymous said...

I could not help but think of a rant on a medically oriented blog lamenting the fact that some government employees have not been given new iPhones, but must get a long with a Blackberry. Terrible.

The rush to embrace technology, needed or not, is so great that spending unlimited amounts of tax dollars appears to some people to be the only logical option.

Oh, this was done on a Blackberry.

Steve Lucas

Trevor3130 said...

Oh, Scot, you are a scaremonger. :)
Please allow me to offer an alternative scenario.
The whole service leapt into action, as if they'd been having regular drills, deploying personnel to "stand" at the known points where failure of information flow is more likely to cause harm to patients.
They knew that, as the length of down-time extended, more critical failure points would emerge and they'd have to shift their focus of surveillance.
The finance office shut down, all staff imbued with the spirit of mission, believing it would be wrong to issue another bill until they were assured the care of patients was the best that could be achieved. Billing clerks, instead of physicians, were flat out on their feet delivering lab & imaging requests and reports.
Not one person was seen to sit on his butt, holding a phone while waiting for someone else to pick up at the other end.
Families of patients were amazed by the fluid efficiency, and happily filmed the ED with their smart-phones.
How does that sound?

Anonymous said...

Just another example of how the doctors, nurses, and patients are guimea pigs in the experiments of the vendors,, by the vendors, and for the vendors, paid for by the taxpayers. A double whammy.

Anonymous said...

I spent 13 years as a IT employee in a hospital (not HIT, luckily.) Every time the EMR would suffer an "unplanned downtime", everything was perfectly fine - just like the Iraqi Information Minister would say.

OF COURSE it never hurt patient care. OF COURSE it didn't affect safety. OF COURSE Saddam Hussein is beating the Americans!

I hope no one gets hurt from this "downtime."

InformaticsMD said...

Trevor3130 said...

Oh, Scot, you are a scaremonger. :)

Hospitals are kind of scary places when the EHR is down and there's little or no source of past medical history, other than memory of patients or family.

How does that sound?

Hunky-dorey as we might say in these parts of Southeastern Pennsylvania.

Anonymous said...

I work at this hospital and it has been a real sh*t show, as I am sure you can imagine. How is it even legal for a hospital to operate under these circumstances?

I cannot believe the way the PR people are trying to spin it like patient safety continues to be the priority. I wish I had the cojones to ask the administrators if they would let their loved ones be patients at the hospital during this prolonged down time.

I like my job too much to question the authorities about the ethics (or lack thereof) of this situation.