Friday, July 05, 2013

More Perversity on Health IT Risks, and ... EHR Sense from Nurses on "Nurse Talk", a Syndicated Radio Show

As I mentioned on July 2 at this post, in a June 25, 2013 Bloomberg News article "Digital Health Records’ Risks Emerge as Deaths Blamed on Systems" by technology reporter Jordan Robertson an EHR-harms case in which I am (unfortunately) intimately involved as substitute plaintiff is mentioned: that of the death of my mother.

I'd previously written about EHR-related electronic encounters with truly perverse individuals at my Jan. 2010 post "More on Perversity in the Healthcare IT World: Is Meditech Employing Sockpuppets?" at

There were quite a few thoughtful comments in the reader comments of the June 25, 2013 Bloomberg article, but also the typical callous, incompetent and/or bizarre comments that an anonymous forum invites (really, semi-anonymous, as the website tracks IP's of commenters).  The anonymous comment below stood out from the rest as a worst-case example of perverse defense of health IT (it may have been removed by now):

Pharm Aid 1 week ago

I'm surprised at the poor quality of reporting in this article. 

First, Scot Silverstein has been on jihad against electronic medical records LONG before his dear mother passed away in 2011.  According to Silverstein's own website, he opposed EMRs back as far as 2009.

Second, the article fails to mention Silverstein's conflict of interest here - he works in this space.  Essentially, Silverstein contacts a vendor of EMRs, offers his "consulting" services.  This totally smacks of a shakedown to me.  If they don't hire him, he criticizes them and claims they are killing people.  Don't take my word for it, check out his website and blog.

Third, the number of medical errors from paper-based records is staggering.  According to a study from 7 years ago, a staggering number - 23% - of patients at one health system had medication errors attributed to illegible paper-based charts.  This is roughly consistent with other studies, including the epic IOM report on errors in medicine.

Let me point out the perversities.  I am assuming the comment was not simply deliberately false character assassination and that the writer believed what he/she was writing - which if not, would show the industry's cheerleaders in an even worse light than if the assumption is the poster believes what he/she wrote:

  • No expression of sympathy or remorse at my mother's death, whatever the cause.
  • Gross and almost humorously silly caricature of my "consulting" (which is as expert witness) and defamatory comments.
  • A mysterious invocation of some unnamed article on paper records at one health system.   I note that N=1 for both the mysterious unnamed study and its subject institution, representing the absolute worst regarding drawing conclusions, especially conclusions that we need to spend hundreds of billions of healthcare dollars on what today is largely bad health IT (see definitions of good and bad health IT at the aforementioned Drexel site).
... Among the problems that commonly occur during the course of providing health care are adverse drug events and improper transfusions, surgical injuries and wrong-site surgery, suicides, restraint-related injuries or death, falls, burns, pressure ulcers, and mistaken patient identities.
  •  As to "[my] claims that EHRs are [injuring and] killing people", I merely report what others find - that still others deliberately dismiss (e.g., as "anecdotal") - or ignore. Just the latest example is the ECRI Deep Dive study (  171 health information technology-related problems voluntarily reported during a nine-week period to the ECRI Institute PSO from just 36 hospitalsEight of the incidents reported involved patient harm, and three may have contributed to patient deaths, said the institute.  Other examples appear at HC Renewal.

In summary, there is someone out there who reads Bloomberg and who either 1) supports health IT, but lacks empathy, lacks judgment, and lacks scientific and critical thinking skills or 2) is simply a confabulator and liar.

Perversity regarding health IT needs sunlight - lots of it.


Here's some of that sunlight in a talk program on "Nurse Talk", a nationally syndicated radio show by and for nurses.

Nurse Talk is heard on the air in major metropolitan areas on both the West and East Coasts, and worldwide on the Internet, and has partnerships with the largest groups of nurses in the country.

Listen to the July 3, 2013 program "RNs DeAnn McEwen and Michelle Mahon on Electronic Medical Records" at

-- SS


Anonymous said...

About the talk interview, i found the conduct in the description of how the Cerner employee guides the nurses on what to document, or not, to be appalling.

Anonymous said...

My neighbor just told me today that her EHR has her as a 50 yr. smoker. Of course she is not and is horrified that it says so. That is going to be a pain in the arse- time consuming chore to get deleted from the record.... If ever.

InformaticsMD said...

Anonymous July 5, 2013 at 4:39:00 PM EDT writes:

My neighbor just told me today that her EHR has her as a 50 yr. smoker. Of course she is not and is horrified that it says so. That is going to be a pain in the arse- time consuming chore to get deleted from the record.... If ever.

Many employers will no longer hire smokers. Health insurance companies will also consider this as a liability. Having that on her medical records is problematic and she should insist it be removed immediately.

-- SS

Anonymous said...

I just want to point out that the oft quoted IOM estimate of the # of preventable hospital deaths has long since by shown to be a not-so-simple math error. People should stop quoting this erroneous "evidence." See Hayward RA et al JAMA 2001 & HSR 2007.

Anonymous said...

Our EHR "IPOC" section gives options about whether the patient:
1. Smokes
2. Wants to quit
3. Has made attempts to quit
4. Has no desire to quit
5. Quit and resumed smoking

It has NO option for "patient does not or has never smoked"

If this is part of capturing meaningful use it is biased.
It forces the user to choose the closest to "does not smoke" or click a few more fields to type their own line that "patient does not or has never smoked". Most users are just clicking away and not taking this extra time unknowingly making it appear that we are meeting meaningful use ($$$ from govt).

Also, the user is falsely documenting if choosing a "closest option".

Another issue is Physicians and other healthcare professionals (PT, OT, dietary) are billing for services forcing the RN to "mark as reviewed" if it was something the RN did not see happen or was done when the RN was not working but shows up, can this be construed as fraud if later found in a lawsuit that the patient was charged for something that didn't happen and the RN marked as reviewed?